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Organization

CUSTOM EYES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID WILLIAM WOLOSIN ABOC,NCLEC (OPTICIAN/PRESIDENT)
(702) 564-3678
Entity
Organization

Contact information

Practice address
175 N STEPHANIE ST, SUITE 130, HENDERSON, NV 89074-8829
(702) 564-3678
(702) 564-7552
Mailing address
PO BOX 230747, LAS VEGAS, NV 89105-0747
(702) 564-3678
(702) 564-7552

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
362
NV

Other

Enumeration date
01/19/2008
Last updated
12/03/2013
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