| NPI | 1275002271 |
|---|---|
| Doing Business As | NORTHERN AVENUE EYE CARE |
| Entity Type | Organization |
| Authorized Contact | DARIO LORENZO Sole Member 602-995-8848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |