| Organization Name: | OAK RIDGE OPTICAL DISPENSARY |
| NPI Number: | 1104858273 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY D ARNDT (OPTICIAN/CO OWNER) |
| Mailing Address: | 174 Randolph Rd Oak Ridge |
| State: | TN US |
| Postal Code: | 378305027 |
| Phone Number: | 8654833616 |
| Fax Number: | 8654837611 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 04/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | OD1118 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |