Maisha Optical LLC
Optometrist in Medford, OR. Organization (NPI-2).
NPI number1013603380
StatusActive
Last updated in NPPESJan 10, 2025
Details
- NPI
- 1013603380
- Entity type
- Organization (NPI-2)
- Legal business name
- Maisha Optical LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2023
- Certification date
- Jan 10, 2025
- Last updated
- Jan 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – |
Other names
- Advanced Vision Wellness Center (Doing Business As)
Practice location
1251 E McAndrews Rd Ste 100Medford, OR 97504-6497
Phone 808-264-4810
Mailing address
1251 E McAndrews Rd Ste 100Medford, OR 97504-6497
Phone 808-264-4810
Authorized official
Maisha Langella
Owner
8086777727
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