| NPI | 1174743280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE M BACA Manager 505-888-3991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NM 03074110006) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-08-22 |