Jak Enterprises DBA Jak Optical Laboratories

NPI #1083158372 in Peoria, Illinois

Provider Information

NPI Number
1083158372
Entity Type
Organization
Organization Name
Jak Enterprises DBA Jak Optical Laboratories
Primary Specialty
Eyewear Supplier
Enumeration Date
Dec 6, 2016
Last Updated
Dec 6, 2016

Practice Location

Address
8309 N KNOXVILLE AVE
City
Peoria
ZIP Code
61615-2170
Phone
(800) 654-2833

Authorized Official

Name
DIANA J HALL
Title
PRESIDENT
Phone
(309) 693-9540

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier

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