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General NPI Number Information
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NPI Number | 1285898064
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Entity Type | Organization
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Legal Business Name | MINIX ONE HOUR OPTICAL
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 212 GLENVIEW PLAZA
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City | PRESTONSBURG
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State | KY
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Zip | 41653
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Country | US
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Telephone | 606-789-2020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1687
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City | PAINTSVILLE
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State | KY
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Zip | 41240-5687
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Country | US
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Telephone | 606-789-2020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARC S MINIX
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Credential | DO
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Telephone | 606-789-2020
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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 |
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License Number State | KY
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