| NPI | 1356502884 |
|---|---|
| Doing Business As | STATESBORO EYEWEAR |
| Entity Type | Organization |
| Authorized Contact | PHILIP L BERTUCCI Owner 912-764-7010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 435023614) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |