Organization
THUNDERCLOUD OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES FIELDER LDO (GENERAL MANAGER/ LICENSED OPTICIAN)
(602) 200-9803
Entity
Organization
Contact information
Practice address
4515 N 16TH ST STE 112, PHOENIX, AZ 85016-5362
(602) 200-9803
(602) 200-9804
Mailing address
4515 N 16TH ST STE 112, PHOENIX, AZ 85016-5362
(602) 200-9803
(602) 200-9804
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1305E
AZ
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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