| NPI | 1841322633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK A LARSEN Director Of Operations Optician 860-444-7360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CT 1317) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |