Organization
SPEEDWAY OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID HARRISON OWEN JR. (OPTICIAN)
(317) 243-7397
Entity
Organization
Contact information
Practice address
1602 CUNNINGHAM DR, INDIANAPOLIS, IN 46224
(317) 243-7397
(317) 247-1442
Mailing address
1602 CUNNINGHAM DR, SPEEDWAY, IN 46224
(317) 243-7397
(317) 247-1442
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
0002331748
IN
Other
Enumeration date
05/25/2007
Last updated
10/09/2007
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