| NPI | 1265619951 |
|---|---|
| Doing Business As | PORTAGE EYECARE CENTER |
| Entity Type | Organization |
| Authorized Contact | THEA L TRAVIS Vice President 269-372-0075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2008-01-25 |