| NPI | 1366429599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ALLEN BEALL Owner 229-247-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA 598) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-12-11 |