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MRS. KATHE S CHAMPAGNE OPTICIAN

Optician >> Technician/Technologist >> Eye and Vision Services Providers

Registrant NPI Number: 1881865061

Individual Registrant:
MRS. KATHE S CHAMPAGNE OPTICIAN
Gender: F
Sole Proprietor

Location and contact information for practice:
12999 6TH STREET  LILLIAN, AL 36549-4107 US
Tel: 251-962-3077  Fax: 251-962-3083

Contact information for business:
12999 6TH ST  LILLIAN, AL 36549-4107 US
Tel: 251-962-3077  Fax: 251-962-3083

Registration Information:
NPI: 1881865061
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y156FX1800XEye and Vision Services Providers
Technician/Technologist
Optician
AL96872008

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICARE0822990001AL01




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