Organization · Type 2 NPI
Grand Lake Optical, LLC
Eyewear Supplier · Grove, OK
NPI number
1649383191
Active
Practice location
1120 Neo Loop
Grove, OK 74344
Fax (918) 787-6002
Mailing address
P.o. Box 451627
Grove, OK 74345
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Eyewear Supplier Primary | 332H00000X | None listed |
Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
4 other providers at this address
About NPI 1649383191
Grand Lake Optical, LLC's National Provider Identifier is 1649383191, issued on Aug 17, 2006. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Grove, OK. The record was last updated on Nov 18, 2010.