Lakeside Optical Dispensary, Inc.
NPI #1780648824 in Moses Lake, Washington
Provider Information
- NPI Number
- 1780648824
- Entity Type
- Organization
- Organization Name
- Lakeside Optical Dispensary, Inc.
- Primary Specialty
- Technician/Technologist - Optician
- Enumeration Date
- Apr 14, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1020 W IVY AVE
- City
- Moses Lake
- State
- Washington
- ZIP Code
- 98837-2049
- Phone
- (509) 765-3497
Authorized Official
- Name
- MR. KEVIN CARVO
- Title
- PRESIDENT
- Phone
- (509) 765-3497
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
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