Organization
TWELVE THIRTY OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA G IRVIN LICENSED OPTICIAN (OWNER CONTACT LENS TECHNICIAN)
(513) 829-8808
Entity
Organization
Contact information
Practice address
1117 MAGIE AVE, FAIRFIELD, OH 45014-1823
(513) 829-8808
(513) 829-5305
Mailing address
1117 MAGIE AVE, FAIRFIELD, OH 45014-1823
(513) 829-8808
(513) 829-5305
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
SC1577
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141502
COLE MANAGED VISION
OH
01
—
23706
SPECTERA
OH
01
—
30569
DAVIS VISION
OH
01
—
OH1577
EYE MED
OH
Enumeration date
04/03/2007
Last updated
08/22/2020
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