| NPI | 1104101211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENET MELTON Optometrist 406-449-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MT MT 604) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2011-10-20 |