| NPI | 1699132142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFREDO DELEON O PT Ician/Owner 267-879-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |