NPI | 1922052935 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA RENEE NICHOLS Practice Manager 941-794-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL DO954) |
Enumeration Date | 2006-05-22 |
Last Update Date | 2008-04-20 |