| NPI | 1760517833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW EDWARD SCHMIDT Medical Director 708-361-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-10-30 |