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General NPI Number Information
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NPI Number | 1497824593
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Entity Type | Organization
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Legal Business Name | NEVADA OPTICAL AND PUBLISHING ENTERPRISES FOR PROFESSIONAL LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 2400 W CHARLESTON BLVD STE D
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City | LAS VEGAS
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State | NV
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Zip | 89102-2152
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Country | US
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Telephone | 702-870-5911
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 W CHARLESTON BLVD STE D
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City | LAS VEGAS
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State | NV
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Zip | 89102-2152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. BETTY WILLIAMS
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Credential |
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Telephone | 702-870-5911
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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 | 296
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License Number State | NV
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