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Organization

LE CLAIR'S OPTICAL, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRANDON RAY BOWEN (PRESIDENT)
(270) 351-5367
Entity
Organization

Contact information

Practice address
171 E LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-1253
(270) 351-5367
(270) 319-4929
Mailing address
171 E LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-1253
(270) 351-5367
(270) 319-4929

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
108328
KENTUCKY SALES & USE TAX ACCOUNT
KY
Enumeration date
06/10/2021
Last updated
06/10/2021
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