| NPI | 1619110087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA HENDERSON Coder 317-849-9921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 18001512a) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2009-04-14 |