NPI | 1699331082 |
---|---|
Doing Business As | SHOPKO OPTICAL 4119 |
Entity Type | Organization |
Authorized Contact | RUSSELL STEINHORST CEO 920-429-7489 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier |
Enumeration Date | 2019-05-12 |
Last Update Date | 2019-12-16 |