Organization
OPTICAL SHOP OF KALISPELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S MATOLA (OWNER)
(406) 755-9001
Entity
Organization
Contact information
Practice address
35 MAIN ST STE B, KALISPELL, MT 59901-4448
(406) 755-9001
Mailing address
35 MAIN ST STE B, KALISPELL, MT 59901-4448
(406) 755-9001
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
C187758-906105
MT
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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