| NPI | 1073505053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND D RUPURED C Fo 770-932-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: GA ga1214) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2008-06-17 |