| NPI | 1912179565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY B FORD President 334-230-9694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: AL s910 ta465) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |