NPI | 1861677007 |
---|---|
Entity Type | Organization |
Authorized Contact | REBEKAH YVONNE BRADTKE Owner 563-875-2344 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2008-01-07 |
Last Update Date | 2008-01-07 |