| NPI | 1831379163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALLEN MALLATT Owner 620-231-1720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: KS KS 1173-2) |
| Enumeration Date | 2007-11-03 |
| Last Update Date | 2010-04-20 |