Provider Demographics
NPI:1457557670
Name:QUALITY OPTICAL LAB, INC.
Entity Type:Organization
Organization Name:QUALITY OPTICAL LAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:SPEAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-278-4603
Mailing Address - Street 1:59 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1928
Mailing Address - Country:US
Mailing Address - Phone:517-278-4603
Mailing Address - Fax:517-278-9423
Practice Address - Street 1:59 S MONROE ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1928
Practice Address - Country:US
Practice Address - Phone:517-278-4603
Practice Address - Fax:517-278-9423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier