| NPI | 1912012527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA G DAUGHERTY Office Manager 540-667-7482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-02-06 |