| NPI | 1952489064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE R BRYANT Ophthalmic Technician 410-757-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0013809) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-10-13 |