| NPI | 1962431700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SCHAFE Manager 239-936-0332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: FL 2348) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2009-01-21 |