| NPI | 1114261328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY B WESTERFELD Md 508-994-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2020-07-16 |