Russ Uptown Optical INC
NPI #1548483639 in Des Moines, Iowa
Provider Information
- NPI Number
- 1548483639
- Entity Type
- Organization
- Organization Name
- Russ Uptown Optical INC
- Primary Specialty
- Technician/Technologist - Optician
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Dec 28, 2012
Practice Location
- Address
- 4122 UNIVERSITY AVE
- City
- Des Moines
- State
- Iowa
- ZIP Code
- 50311-3533
- Phone
- (515) 279-3189
Authorized Official
- Name
- MR. DOUGLAS PHILLIP MENTZER
- Title
- PRESIDENT
- Phone
- (515) 279-3189
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
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