| NPI | 1629512025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R JANSEN Optician 319-824-3718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |