Organization
AICO OPTICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AILEEN HEASTON O.D. (PRESIDENT)
(260) 489-3996
Entity
Organization
Contact information
Practice address
10301 DAWSONS CREEK BLVD, SUITE 2A, FORT WAYNE, IN 46825-1955
(260) 489-3996
(260) 497-8612
Mailing address
10301 DAWSONS CREEK BLVD, SUITE 2A, FORT WAYNE, IN 46825-1955
(260) 489-3996
(260) 497-8612
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
18002550B
IN
Other
Enumeration date
03/23/2008
Last updated
03/23/2008
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