| NPI | 1639252273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI M DE ROSSO Owner 815-963-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-11-07 |