| NPI | 1720232648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUDE LUCILLE HOUGH Owner 352-377-0532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: FL 3940) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: FL 5019) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2015-08-21 |