| NPI | 1447402193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KENNETH JACKSON Owner & Optician 410-664-4508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MD 072195) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |