| NPI | 1730444779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KAY RUPRECHT O PT Ometrist/Sole Owner 208-749-1396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: ID ODP-1036) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-05 |