| NPI | 1346432044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M TODD VANBUSKIRK Licensed Optician 239-649-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL de0000110) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2010-06-28 |