| NPI | 1801191960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL HATHY Doctor 904-292-3976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL FL-OPC-2361) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2011-01-21 |