Organization
DIANE W WHALEY ON THE GO OPTICAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE WADE WHALEY ABOC (OWNER/OPTICIAN)
(318) 747-9227
Entity
Organization
Contact information
Practice address
2801 NORTHSIDE DR, STE B, BOSSIER CITY, LA 71111-5810
(318) 747-9227
Mailing address
2801 NORTHSIDE DR, STE 9, BOSSIER CITY, LA 71111-1700
(318) 747-9227
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
02/15/2008
Last updated
06/01/2010
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