| NPI | 1821399783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DAVID JACO Optometrist 270-753-2842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1292DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1767DT) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |