| NPI | 1205300688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BECKER Administrator 717-397-4724 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2020-06-03 |