| NPI | 1780039115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Dir. Healthcare Contracting 479-277-1242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |