Organization · NPI-2

Blandford Optical Shop

Eyewear Supplier (Equipment, not the service) · Little Rock, AR

NPI number1073522611
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1073522611
Entity type
Organization (NPI-2)
Legal business name
Blandford Optical Shop
Organization subpart
No
Enumeration date
Aug 5, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332H00000X Eyewear Supplier (Equipment, not the service)––Yes

Practice location

5 Saint Vincent Cir
Suite 101
Little Rock, AR 72205-5412

Phone 501-664-6123

Mailing address

5 Saint Vincent Cir
Suite 101
Little Rock, AR 72205-5412

Phone 501-664-6123

Authorized official

David Rodney Rozas
Owner
5016646123

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