| NPI | 1568596898 |
|---|---|
| Doing Business As | EYEGLASS OUTLET & SUPPLY |
| Entity Type | Organization |
| Authorized Contact | KENNETH CLIFFORD JOHNSON President 231-946-5809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |