| NPI | 1457961096 |
|---|---|
| Doing Business As | CANYON LAKE OPTICAL |
| Entity Type | Organization |
| Authorized Contact | JULIA LADD Owner 830-522-4069 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2021-06-09 |