| NPI | 1518105121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL IMLER Member 815-973-5043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IL 036-107453) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-08-19 |