| NPI | 1063005866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L HENDRIX Od/Owner 910-520-6951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-03-18 |