| NPI | 1720461643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL FLYNN Practice Administrator 843-725-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2018-01-10 |