| NPI | 1275668378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WACHTER Cmo 636-200-4393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: AL SB04TA712) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-12-17 |