Organization
THE OPTICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAURO LEIVA OPTICIAN (OWNER/OPTICIAN)
(985) 288-4464
Entity
Organization
Contact information
Practice address
2160 GAUSE BLVD E, SUITE 101, SLIDELL, LA 70461-4227
(985) 288-4464
(985) 288-4465
Mailing address
2160 GAUSE BLVD E, SUITE 101, SLIDELL, LA 70461-4227
(985) 288-4464
(985) 288-4465
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
22048
LA
Other
Enumeration date
08/27/2009
Last updated
08/27/2009
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