| NPI | 1013002492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERAMIAH THOMAS DONELSON Owner 740-389-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: OH s7159) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-03-26 |