| NPI | 1821122144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY WESLEY MULLEN Owner President 804-285-7307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101038524) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2010-06-28 |