| NPI | 1558239830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CANONIC Director Of Health Care Contracting 480-277-6348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |