| NPI | 1164690277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY WOLF Owner 423-477-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN OD0000001369) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |