Organization
ROLLA OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IFEANYI S ORIZU SR. M.D. (OWNER)
(573) 364-5600
Entity
Organization
Contact information
Practice address
720 S BISHOP AVE, ROLLA, MO 65401-4317
(573) 364-5600
Mailing address
720 S BISHOP AVE, ROLLA, MO 65401-4317
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
4710340001
MO
Other
Enumeration date
06/05/2007
Last updated
05/09/2008
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