| NPI | 1821449299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Director, Healthcare Contracting 479-204-8550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-08-09 |