| NPI | 1063689834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER CLARK Manager/Licensed O PT Ician 540-776-9722 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: VA 1101 000964) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2015-06-15 |