| NPI | 1053188789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE GARVEY Director Of Health Care Contracting 479-277-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-04 |