| |
114 Southpark Circle, C/o Sears Optical, Colonial Heights, VA 23834 | |
(804) 277-4410 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 114 Southpark Circle, Colonial Heights, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760567051 | NPI | - | NPPES |
006304010 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
P.o. Box 184, Richmond, VA 23219 Ph: (804) 277-4410 | 114 Southpark Circle, C/o Sears Optical, Colonial Heights, VA 23834 Ph: (804) 277-4410 |