Organization
FASHION OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLACE B. JOHNSTON (OPTICIAN)
(219) 923-6088
Entity
Organization
Contact information
Practice address
8128 KENNEDY AVE, HIGHLAND, IN 46322-1127
(219) 923-6088
Mailing address
8128 KENNEDY AVE, HIGHLAND, IN 46322-1127
(219) 923-6088
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0016898600018
IN
Other
Enumeration date
03/23/2007
Last updated
07/21/2008
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