| NPI | 1982633897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP EARL AGEE Chief Manager 731-784-1186 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2008-05-15 |