Rolla Optical

NPI #1912109398 in Rolla, Missouri

Provider Information

NPI Number: 1912109398
Entity Type: Organization
Organization Name: Rolla Optical
Primary Specialty: Eyewear Supplier
Enumeration Date: Jun 5, 2007
Last Updated: May 9, 2008

Practice Location

Address: 720 S BISHOP AVE
City: Rolla
State: Missouri
ZIP Code: 65401-4317
Phone: (573) 364-5600

Authorized Official

Name: DR. IFEANYI S ORIZU SR., M.D.
Title: OWNER
Phone: (573) 364-5600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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