| NPI | 1558583781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH EDWARD PLOURD Owner 860-633-7889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: CT 001489) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-06-17 |