| NPI | 1790988079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY HARMON Managed Care Coordinatpr 704-405-4183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-01-07 |