Healthcare Provider Details

I. General information

NPI: 1508284191
Provider Name (Legal Business Name): GRABOWSKI OCULAR PROSTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MINERAL KING AVE SUITE 202
VISALIA CA
93291-6923
US

IV. Provider business mailing address

300 E MINERAL KING AVE SUITE 202
VISALIA CA
93291-6923
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-3937
  • Fax: 559-625-3942
Mailing address:
  • Phone: 559-625-3937
  • Fax: 559-625-3942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN EDWARD GRABOWSKI
Title or Position: MEMBER
Credential: BCO BADO
Phone: 559-625-3937