NPI 1306016407

Lg Optical Enterprises

Organisation Eyewear Supplier Brookings, SD

Practice location

Address: 952 22nd Ave S, Brookings, SD 57006-2830
Phone: (605) 692-8262
Fax: (605) 692-9805

Authorised official

Name: Lynn Gannon
Title: Owner
Phone: (605) 692-8262

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X Licence 05001593786886EST001 (SD)

Other Eyewear Supplier providers in South Dakota →

Registry record

NPI: 1306016407
Entity type: Organization
NPI issued: 4 Mar 2008
Record last updated: 4 May 2015

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.