| NPI | 1033377866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMISON J HEFFRON Owner 270-629-2015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2015-07-27 |