NPI | 1831152800 |
---|---|
Doing Business As | WALLACE OPTICAL SHOP |
Entity Type | Organization |
Authorized Contact | GAIL NANETTE BRYANT Business Manger 501-624-0609 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2006-04-10 |
Last Update Date | 2008-06-12 |