| NPI | 1235549536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL WADE Owner 678-834-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: GA LDO002220) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2020-04-10 |