| NPI | 1225166895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE C PECK O PT Ician 606-564-8794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: KY 2826372) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: KY 941) |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: KY 079545) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2018-01-31 |