Organization
OPTOMETRY CLINIC,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONNY M LAQUEY O.D. (PRESIDENT)
(580) 255-0249
Entity
Organization
Contact information
Practice address
2120 W ELK AVE RM 1, DUNCAN, OK 73533-1576
(580) 255-0249
(580) 255-0258
Mailing address
2120 W ELK AVE RM 1, DUNCAN, OK 73533-1576
(580) 255-0249
(580) 255-0258
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
801
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100768480B
—
OK
Enumeration date
05/03/2007
Last updated
09/24/2008
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