Organization
CHICO OPTICAL DISPENSERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDEL EDWARD JOHANSON (OWNER)
(530) 895-1474
Entity
Organization
Contact information
Practice address
1722 MANGROVE AVE STE 32, CHICO, CA 95926-2300
(530) 895-1474
(530) 895-1441
Mailing address
1722 MANGROVE AVE STE 32, CHICO, CA 95926-2300
(530) 895-1474
(530) 895-1441
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
CA
Other
Enumeration date
02/01/2008
Last updated
02/06/2008
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