| NPI | 1548383300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA JEAN TARASOVICH Optician Owner 518-540-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2018-03-02 |