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General NPI Number Information
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NPI Number | 1922251156
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Entity Type | Organization
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Legal Business Name | HARDER OPTOMETRY
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 1079 EUCALYPTUS ST SUITE B
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City | MANTECA
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State | CA
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Zip | 95337-4317
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Country | US
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Telephone | 209-823-2107
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Fax |
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Provider Business Mailing Address
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Address Line | 1079 EUCALYPTUS ST SUITE B
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City | MANTECA
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State | CA
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Zip | 95337-4317
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Country | US
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Telephone | 209-823-2107
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Fax |
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Authorized Official
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Title or Position | OPTI CIAN
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Name | LEEANN SMITH
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Credential |
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Telephone | 209-823-2107
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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 | 6501
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License Number State | CA
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