Organization Name: | PINNACLE OPTICAL LLC |
NPI Number: | 1922432574 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREG BLACKWELL (MANAGING PARTNER) |
Mailing Address: | 1900 Crestwood Blvd Ste 304 Irondale |
State: | AL US |
Postal Code: | 352102034 |
Phone Number: | 2059514466 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2013 |
NPI Last Update Date: | 08/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |