Organization Name: | NORTH POLE OPTICAL, INC |
NPI Number: | 1508281551 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LESLIE E BROCKELSBY (PRESIDENT) |
Mailing Address: | 145 S Santa Claus Ln North Pole |
State: | AK US |
Postal Code: | 997057702 |
Phone Number: | 9074889462 |
Fax Number: | 9074882170 |
NPI Enumeration Date: | 02/27/2014 |
NPI Last Update Date: | 02/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 49 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |