Organization
LAPORTE FAMILY VISION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA J HEYNE-THOMPSON O.D. (OWNER & PRESIDENT)
(219) 326-7681
Entity
Organization
Contact information
Practice address
1231 N STATE ROAD 39, LA PORTE, IN 46350-2042
(219) 326-7681
Mailing address
1231 N STATE ROAD 39, LA PORTE, IN 46350-2042
(219) 326-7681
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002633 A & B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247510
PTAN
IN
Enumeration date
09/16/2006
Last updated
12/17/2008
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