| NPI | 1497852941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW PETERSEN Member 801-576-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: UT 56925) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2019-02-15 |