| NPI | 1669749388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ROY PRUDEN O PT Ometrist 252-237-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: NC 746) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-28 |