| NPI | 1497139885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HETHER BUHLER Administrator 386-734-2931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |