NPI | 1609904663 |
---|---|
Other Name | DR. JOHN LACKEY, INC. |
Entity Type | Organization |
Authorized Contact | JOHN LACKEY Owner 304-872-6433 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: WV 736) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2011-11-03 |