| NPI | 1174787873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DWAINE BERGER Owner Optician 724-836-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: PA 6000001146) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-08-07 |