| NPI | 1760677058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J WHITELEY Owner 219-696-7191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 18002511B) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |