| NPI | 1891183430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY KATHLEEN LEERVIG Owner 651-688-3486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MN 759560400029) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2016-01-06 |