| NPI | 1578584686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAROD LEE Owner 662-328-5781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2018-06-21 |