Organization
LIGHTHOUSE OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DAVID MAXWELL (SEC/TRES.)
(701) 352-2916
Entity
Organization
Contact information
Practice address
317 COOPER AVE, GRAFTON, ND 58237
(701) 352-2916
Mailing address
317 COOPER AVE, GRAFTON, ND 58237
(701) 352-2916
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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