NPI | 1659005262 |
---|---|
Doing Business As | SHOPKO OPTICAL 4289 |
Entity Type | Organization |
Authorized Contact | JAMES EISEN CEO 920-429-7549 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2022-07-11 |
Last Update Date | 2022-07-11 |