Organization Name: | LAKES REGION OPTICIANS INC |
NPI Number: | 1508902164 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CLAYTON RICHARD IRVING (CEO) |
Mailing Address: | 240 S Main St Medical Arts Center Wolfeboro |
State: | NH US |
Postal Code: | 038944411 |
Phone Number: | 6035695442 |
Fax Number: | 6035694378 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 08/24/2007 |
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: |