| NPI | 1407986235 |
|---|---|
| Former Legal Business Name | PARK WEST OPTICAL CO. |
| Entity Type | Organization |
| Authorized Contact | LARRY G RAUEN Administrator 865-524-9871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-02-06 |