| NPI | 1578606224 |
|---|---|
| Other Name | OPTICAL SHOP |
| Entity Type | Organization |
| Authorized Contact | MARK T COX Owner 660-827-1120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-10-29 |