| NPI | 1790310811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED G SMEDLEY Authorized Official 928-775-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2024-04-19 |