| NPI | 1891108924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BUPATHI DISSANAYAKE-MUSALEM Optometrist 336-392-4261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2308) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2015-10-02 |