| NPI | 1528315447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL G FLYNN Practice Administrator 843-725-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2012-08-09 |