Organization
NORTHERN LIGHTS OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANEL PATCHEN (OPTICIAN)
(701) 258-6776
Entity
Organization
Contact information
Practice address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 258-6776
(701) 258-6848
Mailing address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 258-6776
(701) 258-6848
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
165753 00
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52593
—
ND
Enumeration date
09/27/2006
Last updated
06/08/2012
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