Organization
SUN LAKE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL M PETELIN JR. M.D. (PRESIDENT)
(480) 895-8900
Entity
Organization
Contact information
Practice address
25237 S SUN LAKES BLVD STE 1, SUN LAKES, AZ 85248-6467
(480) 895-8900
(480) 895-5657
Mailing address
25237 S SUN LAKES BLVD STE 1, SUN LAKES, AZ 85248-6467
(480) 895-8900
(480) 895-5657
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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