| NPI | 1831291814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFREDO MANZANO Owner Optician 215-707-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2019-09-30 |