| NPI | 1902382146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD TYLER DAVIS Registered Agent/Owner 336-838-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 201700503) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2023-03-07 |