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General NPI Number Information
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NPI Number | 1497892426
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Entity Type | Organization
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Legal Business Name | NORTHERN OPTICAL INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 301 N LINCOLN RD
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City | ESCANABA
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State | MI
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Zip | 49829-1387
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Country | US
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Telephone | 906-789-0668
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Fax | 906-789-9752
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Provider Business Mailing Address
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Address Line | 229 4TH ST
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City | SIOUX CITY
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State | IA
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Zip | 51101-1401
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Country | US
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Telephone | 712-252-1519
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Fax | 712-252-1916
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEORGE TOKARCZYK
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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 | U
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License Number State | MI
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