| NPI | 1659350064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO O'CONNELL Administrator 410-399-8451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MD 12293235) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2008-06-20 |