| NPI | 1104572213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L HENDRIX Od/Owner 910-520-6951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-02-28 |