| NPI | 1528222668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MILO KELLY Optometrist 440-871-1139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OH 3675) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 3675) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |