| NPI | 1083903769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PATRICK BELLOTTI Member 414-491-0397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2011-04-01 |