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General NPI Number Information
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NPI Number | 1033614755
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Entity Type | Organization
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Legal Business Name | KOPOLOW & GIRISGEN PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 13921 S VIRGINIA ST STE 116
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City | RENO
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State | NV
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Zip | 89511-2911
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Country | US
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Telephone | 702-341-7254
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Fax |
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Provider Business Mailing Address
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Address Line | 4045 SPENCER ST STE A59
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City | LAS VEGAS
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State | NV
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Zip | 89119-9311
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Country | US
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Telephone | 702-733-6764
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Fax | 702-255-5795
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Authorized Official
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Title or Position | OWNER
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Name | STEVE T GIRISGEN
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Credential |
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Telephone | 702-275-5229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | NV
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