| NPI | 1801945019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN ELIZABETH GAY Billing 803-905-8047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: SC 043168838) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2014-03-04 |