Organization
W-J OPTICAL
Active
Other names
optical expression
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ROBERT KINGSLEY (PRESIDENT)
(605) 886-2038
Entity
Organization
Contact information
Practice address
1300 9TH AVE SE, WATERTOWN, SD 57201-5387
(605) 886-2038
Mailing address
1300 9TH AVE SE, WATERTOWN, SD 57201-5387
(605) 886-2038
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9281330
—
SD
Enumeration date
04/10/2008
Last updated
09/05/2008
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