| NPI | 1285861864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B WALLACE Member 318-448-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-22 |