| NPI | 1598487423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP A BASILE O PT Ician 440-943-6858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2022-09-16 |