| NPI | 1942382254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA PAINTER Enrollment Specialist 479-277-1238 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2012-07-09 |