| NPI | 1033303326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA SMITH Billing Manager 219-972-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 18002583A) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2010-10-13 |