| NPI | 1992986467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLAN BLACKLEDGE Optometrist 308-532-1753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NE 953) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2012-02-16 |