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General NPI Number Information
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NPI Number | 1063524171
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Entity Type | Organization
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Legal Business Name | STEINHOFF OPTICAL, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 222 STATE ST
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-1127
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Country | US
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Telephone | 269-982-4237
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Fax | 269-982-7364
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Provider Business Mailing Address
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Address Line | 222 STATE ST
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-1127
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Country | US
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Telephone | 269-982-4237
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Fax | 269-982-7364
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Authorized Official
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Title or Position | TREASURER
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Name | MIKE STEINHOFF
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Credential |
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Telephone | 269-982-4237
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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 |
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Taxonomy #2
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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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