NPI | 1073752176 |
---|---|
Entity Type | Organization |
Authorized Contact | DONALD S FULTON Owner/Provider 203-261-5783 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CT 765) |
Enumeration Date | 2009-02-12 |
Last Update Date | 2010-11-04 |