NPI | 1477176675 |
---|---|
Doing Business As | MY EYELAB |
Entity Type | Organization |
Authorized Contact | JACKIE BENNETT Credentianlind Manager 619-357-6146 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2020-05-21 |
Last Update Date | 2021-02-19 |