| NPI | 1902837453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARNIX E HEERSINK President 334-793-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-10-01 |