Provider Demographics
NPI:1710436449
Name:INTERNATIONAL OPTIQUE INC
Entity Type:Organization
Organization Name:INTERNATIONAL OPTIQUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:ROULEAU
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:303-921-6869
Mailing Address - Street 1:7800 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4885
Mailing Address - Country:US
Mailing Address - Phone:303-755-9880
Mailing Address - Fax:303-338-5994
Practice Address - Street 1:7800 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4885
Practice Address - Country:US
Practice Address - Phone:303-755-9880
Practice Address - Fax:303-338-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty