| NPI | 1558769984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LOUIS TEGENKAMP Licensed Optician 850-434-6387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL DO 830) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |