# LIGHTHOUSE OPTICAL INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508291626
- **Authorized official:** MR. JOHN DAVID MAXWELL (SEC/TRES.)
- **Authorized official phone:** (701) 352-2916

## Contact information

- **Practice address:** 317 COOPER AVE, GRAFTON, ND 58237
- **Practice address phone:** (701) 352-2916
- **Mailing address:** 317 COOPER AVE, GRAFTON, ND 58237
- **Mailing address phone:** (701) 352-2916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | — | NULL | Yes |
| 156FX1800X | Optician | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2013
- **Last updated:** 09/09/2013