Organization
TERRIS FASHION OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI A KIMBALL (OWNER OPTICIAN)
(906) 932-0020
Entity
Organization
Contact information
Practice address
629 W CLOVERLAND DRIVE, SUITE 7, IRONWOOD, MI 49938-2045
(906) 932-0020
(906) 932-8057
Mailing address
629 W CLOVERLAND DRIVE, SUITE 7, IRONWOOD, MI 49938-2045
(906) 932-0020
(906) 932-8057
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38723900
—
WI
Enumeration date
02/23/2007
Last updated
07/21/2022
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