| NPI | 1619653789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RILEY RISTO Managing Member 435-305-9014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-06-23 |