| NPI | 1992982912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA O'BRIEN Licensed O PT Ician 860-928-6321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: CT 000812) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-09-08 |