Organization
LONGE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ROTHEKER (OWNER)
(219) 769-6367
Entity
Organization
Contact information
Practice address
7211 TAFT ST, MERRILLVILLE, IN 46410-3731
(219) 769-6367
(219) 769-7362
Mailing address
7211 TAFT ST, MERRILLVILLE, IN 46410-3731
(219) 769-6367
(219) 769-7362
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
119-20
IN
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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