| NPI | 1447595780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANAE D BERGMAN Manager 815-399-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IL 036-110588) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2013-09-06 |