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General NPI Number Information
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NPI Number | 1700188034
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Entity Type | Organization
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Legal Business Name | EYE-DEAL OPTICAL INC.
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 1950 JOHN F KENNEDY RD
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City | DUBUQUE
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State | IA
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Zip | 52002-3897
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Country | US
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Telephone | 563-557-0995
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 JOHN F. KENNEDY RD.
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City | DUBUQUE
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State | IA
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Zip | 52002
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Country | US
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Telephone | 563-557-0995
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Fax |
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Authorized Official
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Title or Position | OWNDER/OPTICIAN
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Name | MR. ROBERT LOUIS PIERCED II
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Credential |
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Telephone | 563-557-0995
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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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