NPI | 1871155754 |
---|---|
Doing Business As | MY EYELAB RICHARDSON |
Entity Type | Organization |
Authorized Contact | JACKIE BENNETT Credentialing Supervisor 561-433-6009 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2019-07-01 |
Last Update Date | 2021-02-17 |