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General NPI Number Information
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NPI Number | 1245354117
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Entity Type | Organization
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Legal Business Name | OPTICAL EXPERTS INC
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 13660 N 94TH DR STE A2
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City | PEORIA
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State | AZ
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Zip | 85381-4836
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Country | US
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Telephone | 623-815-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 13660 N 94TH DR STE A2
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City | PEORIA
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State | AZ
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Zip | 85381-4836
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | KENN ROSEK
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Credential |
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Telephone | 623-815-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 696
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License Number State | AZ
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