| NPI | 1346453966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON H LOONEY Optician 276-926-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: VA 003309) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-02-11 |