| NPI | 1114095312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW RINACKE Owner 618-465-1712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: IL 1645-6246) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2013-01-08 |