| NPI | 1710376645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DUGGINS Office Manager 765-459-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |