Organization
IMAGE OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON RICHARD PAULINE LICENSED OPTICIAN (PRESIDENT/OPTICIAN)
(502) 895-8135
Entity
Organization
Contact information
Practice address
4121 OECHSLI AVE, LOUISVILLE, KY 40207-5022
(502) 895-8135
(502) 895-8133
Mailing address
4121 OECHSLI AVE, LOUISVILLE, KY 40207-5022
(502) 895-8135
(502) 895-8133
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
388
KY
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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