| NPI | 1922515808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL CONNALLY Office Manager 479-582-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-05-02 |