NPI | 1285012435 |
---|---|
Entity Type | Organization |
Authorized Contact | RONDA BOMAN Insurance Director 812-590-6157 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2015-05-08 |
Last Update Date | 2015-05-08 |