| NPI | 1710118377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA WILLIS Office Manager 270-779-7078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: KY 28184) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-30 |