Tristate Optical, Inc.

NPI 1013903962 - Eyewear Supplier (Equipment, not the service) - 332H00000X

NPI Details
NPI 1013903962
Enumeration Date 09/26/2005
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name JERRY L JERRY
Position VICE PRESIDENT
Phone (260) 436-2020
Fax (260) 436-7628
Practice Location
6424 W JEFFERSON BLVD
FORT WAYNE IN, 46804-6204, US
Phone (260) 436-2020
Fax (260) 436-7628
Business Location
6424 W JEFFERSON BLVD
FORT WAYNE IN, 46804-6204, US
Phone (260) 436-2020
Fax (260) 436-7628
Toxanomy
Taxonomy Code 332H00000X
License State
License Number
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According to our database, Tristate Optical, Inc. NPI is 1013903962, taxonomy code is 332H00000X Tristate Optical, Inc. physically located at 6424 W Jefferson Blvd, Fort Wayne IN, 46804-6204. NPI Number 1033115704 has the healthcare provider type.

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1013903962 NPI number is provided on an as is basis without warranty of any kind. 1013903962 is maintained by the National Plan & Provider Enumeration System. The contents of Tristate Optical, Inc. are for informational purposes only.