| NPI | 1770873655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTY P. UNDERWOOD Dispensing Optician, Owner 812-385-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |