| NPI | 1700960416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK E WALLACE President 517-332-8628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |