| NPI | 1821410747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CLEMENT Manager 203-939-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: CT 00408) |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier | |
| 156FX1800X Technician/Technologist Optician | |
| Enumeration Date | 2014-01-12 |
| Last Update Date | 2015-11-06 |