| NPI | 1548435522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG D ROUCH Manager 1318-442-5045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-06-06 |