Organization
LEWISTON OPTICAL L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN G RANA L.D.O. (OWNER MEMBER)
(208) 746-8100
Entity
Organization
Contact information
Practice address
1313 G ST, LEWISTON, ID 83501-1934
(208) 746-8100
(208) 746-8105
Mailing address
1313 G ST, LEWISTON, ID 83501-1934
(208) 746-8100
(208) 746-8105
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
01/15/2007
Last updated
04/11/2008
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