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General NPI Number Information
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NPI Number | 1922399344
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Entity Type | Organization
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Legal Business Name | OUTLOOK OPTICAL
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 3073 WHITE MOUNTAIN HWY
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City | NORTH CONWAY
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State | NH
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Zip | 03860-7101
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Country | US
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Telephone | 603-356-3039
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5001
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City | NORTH CONWAY
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State | NH
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Zip | 03860-5001
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Country | US
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Telephone | 603-356-3039
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY IORFINO
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Credential | M.D.
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Telephone | 603-356-3039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NH
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