| NPI | 1568991156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP SHANE THOMAS Owner/Optician 812-503-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-06-07 |