Organization
EDMOND OPTICAL SHOP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONNIE B. MASTERS (OWNEROPTICIAN)
(405) 341-6588
Entity
Organization
Contact information
Practice address
920 S BRYANT AVE, SUITE 101, EDMOND, OK 73034-5797
(405) 341-6588
(405) 348-9537
Mailing address
920 S BRYANT AVE, SUITE 101, EDMOND, OK 73034-5797
(405) 341-6588
(405) 348-9537
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
05/16/2007
Last updated
05/20/2010
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