| NPI | 1861626988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CARL JACKSON O PT Ometrist/Owner 202-829-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: DC 615) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2009-05-04 |