NPI 1386820421

Custom Eyes, LLC

Organisation Eyewear Supplier Henderson, NV

Practice location

Address: 175 N Stephanie St Suite 130, Henderson, NV 89074-8829
Phone: (702) 564-3678
Fax: (702) 564-7552
Mailing address: PO Box 230747, Las Vegas, NV 89105-0747

Authorised official

Name: David William Wolosin
Title: Optician/President
Phone: (702) 564-3678

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X Licence 362 (NV)

Other Eyewear Supplier providers in Nevada →

Registry record

NPI: 1386820421
Entity type: Organization
NPI issued: 19 Jan 2008
Record last updated: 3 Dec 2013

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.