| NPI | 1790788677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT S. PROFFITT Owner 308-382-7223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2011-04-21 |