| NPI | 1477619609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BRIDGES Owner 863-682-3226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL 1564) |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2009-11-02 |