Organization
BONAVISTA OPTICS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE J ASHLEY LABOC NCLEC (PRESIDENT)
(808) 634-5118
Entity
Organization
Contact information
Practice address
610 RUNNYMEDE RD, OAKWOOD, OH 45419-3322
(937) 250-1810
(937) 250-1812
Mailing address
610 RUNNYMEDE RD, OAKWOOD, OH 45419-3322
(937) 250-1810
(937) 250-1812
Taxonomy
Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
—
—
332H00000X
Eyewear Supplier
Primary
OP.017041-SC
OH
Other
Enumeration date
08/29/2018
Last updated
11/03/2022
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