| NPI | 1003999087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE D GENTILE Npi COO Rdinator 316-788-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |