| NPI | 1013130483 |
|---|---|
| Doing Business As | SJC-LEBANON-OPTOMETRY |
| Entity Type | Organization |
| Authorized Contact | DONN E. SORENSEN Senior Vice President 417-829-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2011-09-27 |