NPI | 1972561660 |
---|---|
Entity Type | Organization |
Authorized Contact | TINA M BURGESS Credentialing Specialist 252-985-1371 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Additional Taxonomies | 207W00000X Ophthalmology |
Enumeration Date | 2006-05-02 |
Last Update Date | 2008-06-19 |