NPI 1265759724

Optical Center

Organisation Optician Fort Polk, LA

Practice location

Address: 7742 Colorado Ave Bldg 850, Fort Polk, LA 71459-5306
Phone: (337) 537-8679
Mailing address: 296 Grayson Hwy, Lawrenceville, GA 30046-5737

Authorised official

Name: Susan Edick
Title: Mc Assistant
Phone: (678) 892-3774

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X

Other Technician/Technologist providers in Louisiana →

Registry record

NPI: 1265759724
Entity type: Organization
NPI issued: 23 Apr 2010
Record last updated: 23 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.