| NPI | 1891144259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY CHAD GREEN President 334-289-0466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-773-TA-219) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2022-07-14 |