| NPI | 1821343401 |
|---|---|
| Doing Business As | SHOPKO OPTICAL 788 |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BETTIGA Executive Vice President And COO 920-429-4297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-27 |