| NPI | 1114097359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA LYNN PATRICK Account Manager 616-588-6593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2024-05-22 |