Professional Optical
Eyewear Supplier (Equipment, not the service) in Fargo, ND. Organization (NPI-2).
NPI number1366636599
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1366636599
- Entity type
- Organization (NPI-2)
- Legal business name
- Professional Optical
- Organization subpart
- No
- Enumeration date
- Aug 30, 2007
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | ND | Yes |
Practice location
4344 20th Ave SwFargo, ND 58103-4434
Phone 701-299-0643 · Fax 701-293-0909
Mailing address
4344 20th Ave SwFargo, ND 58103-4434
Phone 701-299-0643 · Fax 701-293-0909
Authorized official
Daniel J Levin
Doctor/Optometrist
7012980643
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