| NPI | 1881708238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH L FONTENOT Medical Director 251-476-4744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-10-29 |