Organization
SHOUSE OPTICAL SERVICE INC
Active
Other names
John W Shouse
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W SHOUSE (OWNER)
(859) 276-1594
Entity
Organization
Contact information
Practice address
101 MALABU DR # 7, LEXINGTON, KY 40503-3141
(859) 276-1594
(859) 277-6421
Mailing address
101 MALABU DR # 7, LEXINGTON, KY 40503-3141
(859) 276-1594
(859) 277-6421
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52902384
—
KY
Enumeration date
07/07/2008
Last updated
11/19/2012
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