| NPI | 1457628182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PETRIE Owner 330-352-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: OH 5057S) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |