| NPI | 1770761462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA GAIL LAGRONE Owner/Optician 912-354-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: GA 1041) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2009-10-08 |