| NPI | 1558485839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG S PENNELL Owner 859-363-3347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1168DT) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: KY 1168DT) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-09-18 |