| NPI | 1437272911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANETTE GRACE BAROWSKY Practice Administrator 910-592-5379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NC 126748) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2009-10-19 |