| NPI | 1972671386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA PIEPER Practice Manager 260-436-7205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 50002512A) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-05 |