| Doctor Name: | MR. GARY MONS |
| NPI Number: | 1043331432 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 69160 Highway 59 Suite 2 Mandeville, LA - 704717781 |
| Business Phone Number: | 9858759171 |
| Business Fax Number: | 9858750115 |
| Mailing Address: | 69160 Highway 59, Suite 2 MANDEVILLE |
| State: | LA |
| Postal Code: | 704717781 |
| Phone Number: | 9858759171 |
| Fax Number: | 9858750115 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |