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General NPI Number Information
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NPI Number | 1356712319
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Entity Type | Organization
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Legal Business Name | BLINK OPTICAL, LLC
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 1826 E 15TH ST STE B
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City | TULSA
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State | OK
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Zip | 74104-4636
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Country | US
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Telephone | 918-747-3937
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Fax | 918-748-8707
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Provider Business Mailing Address
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Address Line | 1826 E 15TH ST STE B
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City | TULSA
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State | OK
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Zip | 74104-4636
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Country | US
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Telephone | 918-747-3937
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Fax | 918-748-8707
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TINA HULL
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Credential |
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Telephone | 918-747-3937
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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 |
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