| NPI | 1356465785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LARSON Owner 920-458-5096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2014-07-08 |