| NPI | 1043452154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE L MANNING Owner 330-336-9177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3551/T547) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OH T547) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2014-05-09 |