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General NPI Number Information
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NPI Number | 1558427740
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Entity Type | Organization
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Legal Business Name | THE OPTICAL CENTER
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 116 W MAIN ST
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-5844
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Country | US
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Telephone | 641-753-5042
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Fax | 641-753-5292
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Provider Business Mailing Address
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Address Line | 116 W MAIN ST
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-5844
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Country | US
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Telephone | 641-753-5042
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Fax | 641-753-5292
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Authorized Official
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Title or Position | OPTICIAN
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Name | JULIE SCHOSSOW
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Credential | ABOC
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Telephone | 641-753-5042
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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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