| NPI | 1851694921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE KAY SKIRVIN Billing Coordinator 318-213-8131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003177a) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2013-07-22 |