| NPI | 1972134997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN A PATTON Administrator 865-687-1232 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 152WL0500X Optometrist Low Vision Rehabilitation | |
| 152WP0200X Optometrist Pediatrics | |
| 152WS0006X Optometrist Sports Vision | |
| 152WV0400X Optometrist Vision Therapy | |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |