| NPI | 1538142989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E TILLMAN Owner 715-736-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2012-02-20 |