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General NPI Number Information
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NPI Number | 1245405695
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Entity Type | Organization
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Legal Business Name | FLINT OPTICAL COMPANY
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 518 S SAGINAW ST
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City | FLINT
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State | MI
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Zip | 48502-1804
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Country | US
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Telephone | 810-235-4607
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Fax | 810-235-5232
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Provider Business Mailing Address
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Address Line | PO BOX 819
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City | FLINT
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State | MI
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Zip | 48501-0819
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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 | ADMINSTRATOR
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Name | MRS. DIANE M PAYNE
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Credential |
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Telephone | 810-235-4607
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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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