Organization
TRENDSETTERS OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK NEWMAN (OWNER)
(870) 577-1076
Entity
Organization
Contact information
Practice address
324 N MASSEY BLVD, NIXA, MO 65714-8307
(417) 725-0303
Mailing address
324 N MASSEY BLVD, NIXA, MO 65714-8307
(417) 725-0303
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310813951
—
MO
05
—
329359111
—
MO
Enumeration date
11/21/2006
Last updated
06/16/2008
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