| NPI | 1811339948 |
|---|---|
| Doing Business As | DISTEFANO OPTICAL |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LYNN HEATHERLY Managing Member 423-280-0696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-08-07 |