| NPI | 1982309571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAILEY LYNN SCHELLING Practice Manager 605-665-9638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-09-19 |