| NPI | 1952464828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS E SHORTRIDGE President 904-355-6245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: FL 00274) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-06-13 |