NPI | 1124206743 |
---|---|
Entity Type | Organization |
Authorized Contact | VELVET L. PREWITT Owner 870-698-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: AR L930710) |
Enumeration Date | 2008-02-06 |
Last Update Date | 2008-02-06 |