Organization
OPTICAL SHOP OF ACADIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE G IPSON (OFFICE MANAGER)
(337) 235-4665
Entity
Organization
Contact information
Practice address
500 SAINT LANDRY ST, LAFAYETTE, LA 70506-4626
(337) 235-4665
(337) 235-0246
Mailing address
500 SAINT LANDRY ST, LAFAYETTE, LA 70506-4626
(337) 235-4665
(337) 235-0246
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1476633
—
LA
Enumeration date
01/09/2007
Last updated
02/14/2011
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