| NPI | 1952571895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY W BLLOMINGBURG Owner 731-989-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN 573) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |