Organization
ROSEBUD OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAN WALLEN (PRESIDENT)
(602) 265-2063
Entity
Organization
Contact information
Practice address
3643 E LAUREL LN, PHOENIX, AZ 85028-1450
(602) 265-2063
(877) 208-8704
Mailing address
3643 E LAUREL LN, PHOENIX, AZ 85028-1450
(602) 265-2063
(877) 208-8704
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AZ
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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