| NPI | 1912440843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FREDERICK Ocularist/Owner 401-584-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: OH O.24) |
| Additional Taxonomies | 156FX1700X Technician/Technologist, Ocularist |
| Enumeration Date | 2016-11-26 |
| Last Update Date | 2025-07-03 |