| NPI | 1598188930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG F JENSEN Owner 920-235-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: WI 1506-35) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |