| NPI | 1366748337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDA OTERO Owner 787-785-3374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: PR 332H00000X) |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |