Organization
LICATA OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES J LICATA LDO (MANAGER/OPTICIAN)
(480) 632-5075
Entity
Organization
Contact information
Practice address
2048 E BASELINE RD, C-6, MESA, AZ 85204-6969
(480) 632-5075
(480) 507-0836
Mailing address
2048 E BASELINE RD, C-6, MESA, AZ 85204-6969
(480) 632-5075
(480) 507-0836
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1185E
AZ
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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