NPI 1700069200

Lopasteeda Derosa Stephens

Organisation Eyewear Supplier Mc Minnville, TN

Practice location

Address: 1035 Smithville Hwy, Mc Minnville, TN 37110-1691
Phone: (931) 473-6865
Mailing address: PO Box 308, Mc Minnville, TN 37111-0308

Authorised official

Name: Lopasteeda Derosa Stephens
Title: Owner
Phone: (931) 473-6865

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X Licence TN1363 (TN)

Other Eyewear Supplier providers in Tennessee →

Registry record

NPI: 1700069200
Entity type: Organization
NPI issued: 7 Dec 2007
Record last updated: 7 Dec 2007

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.