| NPI | 1508803917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN EDICK Mc Asst 678-892-3774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-12-27 |