Organization
LAKES REGION OPTICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAYTON RICHARD IRVING DISPENSING OPTICIAN (CEO)
(603) 569-5442
Entity
Organization
Contact information
Practice address
240 S MAIN ST, MEDICAL ARTS CENTER, WOLFEBORO, NH 03894-4411
(603) 569-5442
(603) 569-4378
Mailing address
PO BOX 1750, WOLFEBORO, NH 03894-1750
(603) 569-5442
(603) 569-4378
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010616
—
NH
Enumeration date
01/30/2007
Last updated
08/24/2007
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