| NPI | 1003081613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN S JOHNSON Administrative Manager 937-853-2854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: OH 4207-S) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2012-01-31 |