| NPI | 1922675974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GARZA Credentialing Manager 561-720-6423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-08 |