| NPI | 1194234849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE KESLAR THOMPSON Executive Administrator 667-214-1197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2017-09-26 |