Organization
PROVIDENCE OPTICIANS DESIGNER EYEWEAR INC
Active
Other names
Providence Opticians Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE E. WINSLOW OPTICIAN (PRESIDENT)
(202) 462-0055
Entity
Organization
Contact information
Practice address
3510 12TH ST NE, WASHINGTON, DC 20017-2544
(202) 526-0300
(202) 526-0233
Mailing address
3510 12TH ST NE, WASHINGTON, DC 20017-2544
(202) 526-0300
(202) 526-0233
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016707300
—
DC
01
—
1538298906
BLOCK VISION
DC
01
—
61444
DAVIS VISION
DC
Enumeration date
01/30/2009
Last updated
01/24/2013
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