| NPI | 1356792899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Director, Healthcare Contracting An 479-258-6180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-06-27 |