| NPI | 1003935867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MCDONOUGH Certified Optician 651-227-8198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |