| NPI | 1821547803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARIE THOMPSON Optometrist 757-491-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA 0618002515) |
| Enumeration Date | 2016-10-01 |
| Last Update Date | 2016-11-22 |