Organization
JOSEPH V SICA SR A PROFESSIONAL OPTOMETRIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH VINCENT SICA O.D. (OPTOMETRIST)
(985) 892-2722
Entity
Organization
Contact information
Practice address
312 S JEFFERSON AVE, COVINGTON, LA 70433-3169
(985) 892-2722
(985) 892-3418
Mailing address
312 S JEFFERSON AVE, COVINGTON, LA 70433-3169
(985) 892-2722
(985) 892-3418
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
631-088T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1040631
—
LA
Enumeration date
04/29/2010
Last updated
01/12/2011
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