| NPI | 1780110924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY LOUIS MATHIS Administrator 727-914-8615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2017-05-09 |