| NPI | 1396932430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A GOSNELL Owner 308-537-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NE 1166) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1166) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2022-10-27 |