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General NPI Number Information
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NPI Number | 1003970344
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Entity Type | Organization
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Legal Business Name | REAL OPTICS INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 2405 INGERSOLL AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5233
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Country | US
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Telephone | 515-244-7740
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Fax | 515-244-6354
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Provider Business Mailing Address
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Address Line | 2405 INGERSOLL AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5233
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Country | US
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Telephone | 515-244-7740
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Fax | 515-244-6354
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Authorized Official
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Title or Position | EMPLOYER
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Name | MR. ISAK SIVI
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Credential |
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Telephone | 515-244-7740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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