Lake Family Vision Center INC

NPI #1720128713 in Laurie, Missouri

Provider Information

NPI Number: 1720128713
Entity Type: Organization
Organization Name: Lake Family Vision Center INC
Primary Specialty: Optometrist
Enumeration Date: Feb 7, 2007
Last Updated: Dec 21, 2007

Practice Location

Address: 138 SOUTH MAIN
Address 2: SUITE C
City: Laurie
State: Missouri
ZIP Code: 65038-1185
Phone: (573) 374-5222

Authorized Official

Name: DR. WILLIAM R SCOGGIN, O.D.
Title: OPTOMETRIST OWNER
Phone: (573) 374-5222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X
Optometrist	152W00000X	Primary

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