| NPI | 1265820815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MARK FARNAN Co Owner 660-783-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: MO 22104119) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |