Organization Name: | LEE EYEWEAR INC |
NPI Number: | 1821193236 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTHA DIANE ROSS (PRESIDENT OWNER) |
Mailing Address: | 2700 E Dupont Ave Ste 10 Belle |
State: | WV US |
Postal Code: | 250151842 |
Phone Number: | 3049495171 |
Fax Number: | |
NPI Enumeration Date: | 09/13/2006 |
NPI Last Update Date: | 05/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |