| NPI | 1053359992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE STAEVEN-COATES Business Manager 920-734-8714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2009-12-16 |