City Optical Co., INC.
Optometrist in Indianapolis, IN. Organization (NPI-2).
NPI number1609045202
StatusActive
Last updated in NPPESOct 27, 2021
Details
- NPI
- 1609045202
- Entity type
- Organization (NPI-2)
- Legal business name
- City Optical Co., INC.
- Organization subpart
- No
- Enumeration date
- Feb 27, 2008
- Certification date
- Oct 27, 2021
- Last updated
- Oct 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
| 152W00000X | Optometrist | 18001649A | IN |
Practice location
2839 Lafayette RdIndianapolis, IN 46222-2147
Phone 317-924-1300 · Fax 855-326-4293
Mailing address
2839 Lafayette RdIndianapolis, IN 46222-2147
Phone 317-924-1300 · Fax 317-924-3741
Authorized official
Larry S Tavel
President
3179241300
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