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General NPI Number Information
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NPI Number | 1144427295
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Entity Type | Organization
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Legal Business Name | PUEBLO OF ZUNI OPTICAL SERVICES
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 1203B ST. HWY. 53 1203B ST. HWY. 53
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City | ZUNI
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State | NM
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Zip | 87327-0339
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Country | US
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Telephone | 505-782-7198
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 339 1203B ST. HWY. 53
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City | ZUNI
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State | NM
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Zip | 87327-0339
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Country | US
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Telephone | 505-782-7198
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MR. LANNY LATONE
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Credential |
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Telephone | 505-782-7198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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