| NPI | 1902144256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA A. GRIST Owner 423-928-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-05-03 |