| NPI | 1215126545 |
|---|---|
| Doing Business As | EDMONDS OPTICIAN |
| Entity Type | Organization |
| Authorized Contact | SAMUEL GEORGE TATE President 301-229-3775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-10-23 |