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General NPI Number Information
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NPI Number | 1538309604
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Entity Type | Organization
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Legal Business Name | OUTPOST OPTICAL INC
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 206 MILITARY RD
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City | NORTH SIOUX CITY
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State | SD
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Zip | 57049-3170
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Country | US
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Telephone | 605-232-3937
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Fax | 605-235-1350
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Provider Business Mailing Address
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Address Line | PO BOX 1993
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City | NORTH SIOUX CITY
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State | SD
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Zip | 57049-1993
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Country | US
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Telephone | 605-232-3937
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Fax | 605-235-1350
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JEFF B RABBITT
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Credential |
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Telephone | 605-232-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0547
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License Number State | SD
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