Organization Name: | SUPERIOR OPTICS INC. |
NPI Number: | 1134313737 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANICE ELAINE CARTER (PRESIDENT) |
Mailing Address: | 1505 Tower Ave Superior |
State: | WI US |
Postal Code: | 548802531 |
Phone Number: | 7153947339 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2007 |
NPI Last Update Date: | 04/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |