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General NPI Number Information
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NPI Number | 1194059436
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Entity Type | Organization
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Legal Business Name | LAFLEUR OPTICAL IMAGE, INC
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 3354 E BROAD ST SUITE C
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City | COLUMBUS
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State | OH
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Zip | 43213-1031
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Country | US
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Telephone | 614-745-1805
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Fax | 614-745-1806
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Provider Business Mailing Address
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Address Line | 3354 E BROAD ST SUITE C
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City | COLUMBUS
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State | OH
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Zip | 43213-1031
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Country | US
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Telephone | 614-745-1805
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Fax | 614-745-1806
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDRE V LEFLORE
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Credential | LICENSED OPTICIAN
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Telephone | 614-745-1805
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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 | S6929
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License Number State | OH
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