NPI | 1740464296 |
---|---|
Entity Type | Organization |
Authorized Contact | TODD SIMS President 773-863-9234 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 046-009243) |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IL 046-009243) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2013-09-11 |