| NPI | 1114161437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN M FORD Practice Administrator 918-250-2020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK 2447) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2010-06-24 |