Tristate Optical, Inc.

NPI #1013903962 in Fort Wayne, Indiana

Provider Information

NPI Number: 1013903962
Entity Type: Organization
Organization Name: Tristate Optical, Inc.
Primary Specialty: Eyewear Supplier
Enumeration Date: Sep 26, 2005
Last Updated: Aug 22, 2020

Practice Location

Address: 6424 W JEFFERSON BLVD
City: Fort Wayne
State: Indiana
ZIP Code: 46804-6204
Phone: (260) 436-2020

Authorized Official

Name: MR. JERRY L BRADLEY
Title: VICE PRESIDENT
Phone: (260) 436-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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