| NPI | 1740925569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MARION Administrator 701-751-3501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-05-05 |