| NPI | 1013496447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY M HIGH Practice Administrator 704-334-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |