| NPI | 1073854543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE ELIZABETH BOUNDS Practice Manager 304-353-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-12 |