| NPI | 1568771608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI LISBURG Optician/Manager 701-298-0643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |