| NPI | 1477330819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEB ODEIN LEE Exec Director Of Operations & Payor 515-663-8663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-12 |