| NPI | 1366560385 |
|---|---|
| Other Name | MAIN OPTICAL |
| Entity Type | Organization |
| Authorized Contact | SANDI OWINGS Practice Administrator 414-828-2012 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: WI 44407) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-11-19 |