Healthcare Provider Details

I. General information

NPI: 1114187051
Provider Name (Legal Business Name): LOOK-SEE VISION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 N MAIN ST
SEMINOLE OK
74868-3428
US

IV. Provider business mailing address

304 N MAIN ST
SEMINOLE OK
74868-3428
US

V. Phone/Fax

Practice location:
  • Phone: 405-788-0016
  • Fax: 405-788-0019
Mailing address:
  • Phone: 405-788-0016
  • Fax: 405-788-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number36344
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number36344
License Number StateOK

VIII. Authorized Official

Name: MR. JEFFERY WILLIAM LEE
Title or Position: OWNER/EXAMINER
Credential: COT, DIHOM
Phone: 405-788-0016