| NPI | 1932395506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRISTER B SHUM Business Manager 901-754-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TN 547) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2009-01-14 |