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General NPI Number Information
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NPI Number | 1669006854
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Entity Type | Organization
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Legal Business Name | NOLLOPTOMETRYLLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 2645 SAINT ROSE PKWY STE C-110
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City | HENDERSON
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State | NV
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Zip | 89052-8905
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Country | US
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Telephone | 714-363-8433
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 SAINT ROSE PKWY STE C-110
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City | HENDERSON
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State | NV
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Zip | 89052
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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 | OWNER
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Name | AIMEE NOLL
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Credential | OD
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Telephone | 714-363-8433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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