| NPI | 1396945218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DAVID LAWLER Owner 731-968-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN odt455) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN odt455) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2009-07-10 |