Organization
NICO ROUSE CORPORATION P S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG ROUSE (PRESIDENT)
(369) 790-1669
Entity
Organization
Contact information
Practice address
504 A STREET, MCCHORD AFB, WA 98438-1304
(253) 588-1731
Mailing address
9321 MILBURN LOOP SE, LACEY, WA 98513-3420
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/30/2008
Last updated
06/26/2017
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