| NPI | 1427505742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA AULTMAN Managed Care COO Rdinator 800-571-5202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2016-09-02 |