| NPI | 1235120619 |
|---|---|
| Doing Business As | CYPRESS LAKE EYEWEAR |
| Entity Type | Organization |
| Authorized Contact | RICHARD M DAVIS President 239-481-3343 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: FL 0000176) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL 000176) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2008-06-25 |