| NPI | 1689924987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA PAINTER Enrollment Specialist 479-277-1238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |