| NPI | 1982906509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REAGAN L FORD Owner 662-323-0571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MS 466) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2024-02-06 |