| NPI | 1831958735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE MAXWELL Managing O PT Ician 401-284-4591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-26 |