NPI | 1093338253 |
---|---|
Entity Type | Organization |
Authorized Contact | JACKIE BENNETT Credentialing Manager 616-357-6146 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2020-05-22 |
Last Update Date | 2021-02-19 |