Organization
PROFESSIONAL OPTICIANS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C HOLTMANN ABO (PRESIDENT)
(859) 278-5409
Entity
Organization
Contact information
Practice address
165 MOORE DR, LEXINGTON, KY 40503
(859) 278-5409
(859) 276-3491
Mailing address
165 MOORE DR, LEXINGTON, KY 40503
(859) 278-5409
(859) 276-3491
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0366
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000066363
ANTHEM BCBS
KY
01
—
14560
AVESIS
KY
05
—
52903663
—
KY
Enumeration date
08/29/2006
Last updated
08/22/2020
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