| NPI | 1891972048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN EVANS ELLIS Dispensing Optician 601-483-1172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2023-07-28 |