| NPI | 1861529240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN R. GILL Owner 301-662-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MD 10199942) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA1338) |
| 152W00000X Optometrist (Licence: MD TA0646) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-03-21 |