| NPI | 1205078292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY C WILKINSON Carrier Specialist 479-204-8320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |