NPI | 1629100011 |
---|---|
Entity Type | Organization |
Authorized Contact | DALE W MUTH Optometrist 906-293-9276 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI 4901003944) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2015-06-09 |