| NPI | 1871726562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A LONG Optometrist 260-484-2720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 18001507) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |