NPI | 1639250053 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN L EGGEBRECHT Optometrist Owner 260-459-9595 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
Enumeration Date | 2006-10-19 |
Last Update Date | 2011-12-06 |