| NPI | 1568467074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY J HETZLER President 317-598-6298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1700X Technician/Technologist Ocularist (Licence: OH 0.11) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: OH O.11) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2020-08-22 |