NPI | 1679103048 |
---|---|
Doing Business As | MY EYELAB |
Entity Type | Organization |
Authorized Contact | JACKIE BENNETT Credentialing Supervisor 561-433-6009 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2020-01-24 |
Last Update Date | 2021-02-18 |