| NPI | 1295913002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA K REYNOLDS O PT Ician 606-679-8469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: KY 929) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2013-05-24 |