| NPI | 1245403377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE BENAVIDES Office Administrator 907-561-1167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2024-12-12 |