| NPI | 1700069200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOPASTEEDA DEROSA STEPHENS Owner 931-473-6865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN TN1363) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |