| NPI | 1245403377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADINE NYBOER Bookeeper 907-561-1167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: AK MD1135) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |