| NPI | 1144427295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANNY LATONE Program Manager 505-782-7198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 231H00000X Audiologist |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2008-07-14 |