| NPI | 1275955122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN IBARRA Medical Biller 215-945-8820 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |