NPI | 1962091272 |
---|---|
Doing Business As | SHOPKO OPTICAL 4234 |
Entity Type | Organization |
Authorized Contact | RUSSELL STEINHORST CEO 920-429-7489 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2021-01-12 |
Last Update Date | 2021-01-12 |