Coffeyville Optic Shop LLC
NPI #1356005961 in Coffeyville, Kansas
Provider Information
- NPI Number
- 1356005961
- Entity Type
- Organization
- Organization Name
- Coffeyville Optic Shop LLC
- Primary Specialty
- Technician/Technologist - Optician
- Enumeration Date
- Oct 29, 2021
- Last Updated
- Oct 29, 2021
Practice Location
- Address
- 2205 W 8TH ST STE B
- City
- Coffeyville
- State
- Kansas
- ZIP Code
- 67337-2950
- Phone
- (620) 251-0050
Authorized Official
- Name
- CYNTHIA M DALE
- Title
- OWNER
- Phone
- (620) 870-4511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
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