| NPI | 1902510977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY SESSOMS HARMON Managed Care Coordinator 704-405-4183 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-01-13 |