Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician | |
Contact Lens |
156FC0800X |
| NPI Number | 1861787624 |
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| LBN Legal business name | IDEAL FORTUNE CO. INC. | ||||
| Authorized official | CARLOS GO - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 06/09/2011 | ||||
| Last updated | 06/09/2011 - About 15 years ago | ||||
| Identifiers |
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