# MAVES OPTICAL

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

## Provider details

- **NPI number:** 1871585869
- **Authorized official:** ELAINE R MAVES (OWNER OPTICIAN)
- **Authorized official phone:** (701) 775-4114

## Contact information

- **Practice address:** 1101 COLUMBIA ROAD SOUTH, GRAND FORKS, ND 58201
- **Practice address phone:** (701) 775-4114
- **Practice address fax:** (701) 772-3237
- **Mailing address:** 1101 COLUMBIA ROAD SOUTH, GRAND FORKS, ND 58201
- **Mailing address phone:** (701) 775-4114
- **Mailing address fax:** (701) 772-3237

## Taxonomy

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

## Other

- **Enumeration date:** 08/17/2005
- **Last updated:** 10/22/2008