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General NPI Number Information
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NPI Number | 1235110446
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Entity Type | Organization
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Legal Business Name | VALLEY OPTICIANS INC.
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 780 NW GARDEN VALLEY BLVD SUITE 50B-1
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City | ROSEBURG
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State | OR
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Zip | 97470-6528
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Country | US
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Telephone | 541-672-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 780 NW GARDEN VALLEY BLVD PO BOX 970
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City | ROSEBURG
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State | OR
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Zip | 97470-6528
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Country | US
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Telephone | 541-672-5400
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Fax |
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Authorized Official
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Title or Position | DISPENCING OPTICIAN
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Name | MR. TODD L. BARNETT
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Credential |
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Telephone | 541-672-5400
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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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