| NPI | 1275999385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSANNE RINDERKNECHT Physician 623-977-8341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: AZ 20524190-C) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |