| NPI | 1659596278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA D MITCHELL Practice Manager 620-223-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-08-11 |