| NPI | 1962087429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE BAKER COO 502-897-1656 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2021-03-26 |