Organization
LAKES REGION OPTICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAYTON RICHARD IRVING (CEO)
(603) 524-2050
Entity
Organization
Contact information
Practice address
212 PROUTY DR, BIRCHWOOD BUILDING, NEWPORT, VT 05855-9851
(802) 334-7001
(802) 334-7001
Mailing address
212 PROUTY DR, BIRCHWOOD BUILDING PO BOX 692, NEWPORT, VT 05855-9851
(802) 334-7001
(802) 334-7001
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006611
—
VT
Enumeration date
01/30/2007
Last updated
08/24/2007
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