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General NPI Number Information
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NPI Number | 1245536564
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Entity Type | Organization
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Legal Business Name | ON SIGHT OPTICAL LLC
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 1818 W GLENHAVEN DR
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City | PHOENIX
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State | AZ
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Zip | 85045-1635
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Country | US
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Telephone | 480-232-0380
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Fax | 480-460-0241
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Provider Business Mailing Address
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Address Line | 1818 W GLENHAVEN DR
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City | PHOENIX
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State | AZ
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Zip | 85045-1635
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Country | US
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Telephone | 480-232-0380
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Fax | 480-460-0241
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Authorized Official
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Title or Position | OWNER/LICENSED OPTICIAN
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Name | MRS. ELIZABETH MARGARET EVANS
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Credential |
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Telephone | 480-232-0380
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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 | 1076E
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License Number State | AZ
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