Organization
LAKES REGION OPTICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAYTON RICHARD IRVING DISPENSING OPTICIAN (CEO)
(603) 524-2050
Entity
Organization
Contact information
Practice address
36 COUNTRY CLUB RD, VILLAGE WEST II, GILFORD, NH 03249-6978
(603) 524-2050
(603) 524-2078
Mailing address
PO BOX 7605, LACONIA, NH 03247-7605
(603) 524-2050
(603) 524-2078
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010616
—
NH
Enumeration date
01/31/2007
Last updated
08/24/2007
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