| NPI | 1982063335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LANE Optometrist/Owner 757-759-1416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001867) |
| Enumeration Date | 2016-02-14 |
| Last Update Date | 2016-02-14 |