| NPI | 1831678127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES FIELDER General Manager/ Licensed O PT Ician 602-200-9803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: AZ 1305E) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |