Organization
FENNO EYE CLINICS INC., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FENNO (PRESIDENT)
(509) 684-5278
Entity
Organization
Contact information
Practice address
102 S OAK ST, COLVILLE, WA 99114-2846
(509) 684-5278
Mailing address
102 S OAK ST, COLVILLE, WA 99114-2846
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1708TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022960
—
WA
Enumeration date
02/12/2007
Last updated
02/03/2010
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