| NPI | 1407058928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAE M FREDENBURG Owner 231-943-4510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2014-10-03 |