| NPI | 1750945028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JOSEPH BAILEN Member/Optician 715-682-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |