| NPI | 1255731683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN CARTER O PT Ician 443-883-3528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: MD 02826600) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |