| NPI | 1609071679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A NICHOLAS Optician 606-528-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: KY 165742) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |