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General NPI Number Information
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NPI Number | 1356535181
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Entity Type | Organization
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Legal Business Name | DAUPHIN OPTICAL
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 108 W I65 SERVICE RD S
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City | MOBILE
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State | AL
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Zip | 36608-5902
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Country | US
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Telephone | 251-344-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 108 W I65 SERVICE RD S
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City | MOBILE
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State | AL
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Zip | 36608-5902
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Country | US
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Telephone | 251-344-8691
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL M RENCHER III
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Credential | M.D.
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Telephone | 251-344-8691
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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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