| NPI | 1700130952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELLODY FERN WILEY Office Manager 765-932-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 18002225) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 18002225) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-08 |