| NPI | 1992703730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A GONCE Secretary 434-977-5160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-08-22 |