| NPI | 1962695700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI K VIRGIL Billing Dept Manager 574-291-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2008-04-30 |