| NPI | 1114089448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTINY DAWN ZIELIE Owner 406-656-9857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: MT 0600022915) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2014-08-05 |