| NPI | 1952309122 |
|---|---|
| Former Legal Business Name | GERRY'S VISION SHOPPE |
| Entity Type | Organization |
| Authorized Contact | HEIDI LYNN KLOCKMANN President 320-864-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2020-08-22 |