| NPI | 1902078520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNETT M DOHERTY Owner Licensed Dispensing Optician 901-761-4292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN OPC325) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-09-24 |