| NPI | 1871763144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE MICHAEL LEVASSEUR Optometrist 860-688-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CT 900) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-04-10 |