| NPI | 1841817426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY NOELL HAVILAND Optometrist/Owner 731-415-7918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |