| NPI | 1487788634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN LINDBERG Owner & Licensed O PT Ician 860-793-9378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: CT CT1106) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: CT 001471) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2015-07-23 |