| NPI | 1821474032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Director Healthcare Contracting 479-277-1242 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |