| NPI | 1871737734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA L DAVIS Optician 865-977-0285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: TN DPO719) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2009-04-22 |