| |
395 S Main St, Rocky Mount, VA 24151-1710 | |
(540) 855-5100 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 395 S Main St, Rocky Mount, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871028209 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 0618001837 (Virginia) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 1789, Roanoke, VA 24008-1789 Ph: (540) 855-5100 | 395 S Main St, Rocky Mount, VA 24151-1710 Ph: (540) 855-5100 |