| NPI | 1134503352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP K BAGGA President 970-245-6821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: CO 042267650000) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |