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General NPI Number Information
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NPI Number | 1508533969
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Entity Type | Organization
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Legal Business Name | 406 ROLLIN' EYES
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 1844 BROADWATER AVE STE 5
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City | BILLINGS
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State | MT
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Zip | 59102-4875
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Country | US
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Telephone | 406-797-2020
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Fax | 406-797-7227
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Provider Business Mailing Address
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Address Line | 1844 BROADWATER AVE STE 5
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City | BILLINGS
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State | MT
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Zip | 59102-4875
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Country | US
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Telephone | 406-797-2020
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Fax | 406-797-7227
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Authorized Official
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Title or Position | OWNER/ABO CERTIFIED OPTICIAN
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Name | MRS. SALICIA BORGES
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Credential |
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Telephone | 406-797-2020
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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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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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