| NPI | 1639646987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY RICHARD CLARKE Optician/Optical Manager 434-425-4025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |