| NPI | 1164690681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA J LAIS Optician 417-623-3448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-21 |