The Optical Gallery
Technician/Technologist, Optician in Ruther Glen, VA. Organization (NPI-2).
NPI number1033239017
StatusActive
Last updated in NPPESAug 12, 2008
Details
- NPI
- 1033239017
- Entity type
- Organization (NPI-2)
- Legal business name
- The Optical Gallery
- Organization subpart
- No
- Enumeration date
- Mar 31, 2007
- Last updated
- Aug 12, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 1101 002527 | VA | Yes |
Practice location
17484 D Center DriveRuther Glen, VA 22546-2839
Phone 804-448-0900 · Fax 804-448-4470
Mailing address
17484 D Center DriveRuther Glen, VA 22546-2839
Phone 804-448-0900 · Fax 804-448-4470
Authorized official
Sheila Baxter Yackel
Optician Owner
8044480900
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