| NPI | 1225578529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLEE FISHER Manager 479-204-1258 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |