| NPI | 1619146883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A COCHRAN Owner 662-289-9581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MS 056063) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-06-11 |