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 |