| NPI | 1043818859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GUY FARRELL Owner 586-322-1875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |