Organization
QUALITY OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R FENWICK O.D. (OWNER)
(574) 825-3818
Entity
Organization
Contact information
Practice address
424 N MAIN ST, SUITE 4, MIDDLEBURY, IN 46540-8988
(574) 825-3818
(574) 825-9497
Mailing address
424 N MAIN ST, SUITE 4, MIDDLEBURY, IN 46540-8988
(574) 825-3818
(574) 825-9497
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100325370
—
IN
Enumeration date
03/29/2006
Last updated
04/04/2008
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