| NPI | 1407204761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN A SMITH Sole Owner 315-363-6210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-04-05 |