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General NPI Number Information
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NPI Number | 1316097413
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Entity Type | Organization
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Legal Business Name | TKC OPTICAL INC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1700 MARKET LN
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City | NORFOLK
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State | NE
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Zip | 68701-7373
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Country | US
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Telephone | 402-371-8900
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Fax | 402-371-6040
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Provider Business Mailing Address
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Address Line | 1700 MARKET LN
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City | NORFOLK
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State | NE
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Zip | 68701-7373
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Country | US
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Telephone | 402-371-8900
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Fax | 402-371-6040
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVE P CONLEY
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Credential |
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Telephone | 712-252-1519
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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 | NE
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