Organization
OPTIC SHOP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATH V HAFFENER D.C. (PART OWNER)
(620) 252-8047
Entity
Organization
Contact information
Practice address
2205 W 8TH ST, COFFEYVILLE, KS 67337-2936
(620) 251-0050
(620) 688-6055
Mailing address
2205 W 8TH ST, COFFEYVILLE, KS 67337-2936
(620) 251-0050
(620) 688-6055
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/20/2018
Last updated
06/05/2019
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