| NPI | 1063610046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD G SCHAEFGEN Optician President 815-455-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |