Organization
LONGE OPTICAL
Active
Parent organization
LONGE OPTICAL NORTH INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONGE OPTICAL NORTH INC.
Authorized official
MRS. MARTHA C. DAVENPORT (MANAGER)
(260) 347-1128
Entity
Organization
Contact information
Practice address
625 W NORTH ST, KENDALLVILLE, IN 46755-1009
(260) 347-1128
(260) 347-4948
Mailing address
625 W NORTH ST, KENDALLVILLE, IN 46755-1009
(260) 347-1128
(260) 347-4948
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100173460
—
IN
Enumeration date
09/17/2009
Last updated
09/17/2009
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