| NPI | 1841531977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER STREET CHILDERS Optometrist/Sole Owner 662-512-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 855) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2014-01-10 |