Organization Name: | DALE J MOSER |
NPI Number: | 1053615708 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DALE J MOSER (OWNER) |
Mailing Address: | 1520 N Mcewan St Clare |
State: | MI US |
Postal Code: | 48617 |
Phone Number: | 9893862020 |
Fax Number: | 9893867308 |
NPI Enumeration Date: | 01/10/2011 |
NPI Last Update Date: | 04/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 003085 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |