Organization
RX OPTICAL LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN J JEPSON (PRESIDENT)
(269) 342-0003
Entity
Organization
Contact information
Practice address
930 E MICHIGAN AVE, SALINE, MI 48176-1586
(269) 342-0003
Mailing address
1825 S PARK ST, KALAMAZOO, MI 49001-2762
(269) 342-0003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C976550
BCBS
MI
Enumeration date
04/25/2019
Last updated
04/25/2019
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