NPI | 1326019829 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENT LEE WILDE President/COO 952-567-6043 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MN 1751) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2017-04-24 |