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Gresham Optical, INC

Eyewear Supplier (Equipment, not the service) in Gresham, OR. Organization (NPI-2).

NPI number1760636005
StatusActive
Last updated in NPPESAug 27, 2015

Details

NPI
1760636005
Entity type
Organization (NPI-2)
Legal business name
Gresham Optical, INC
Organization subpart
No
Enumeration date
Nov 13, 2008
Last updated
Aug 27, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332H00000X Eyewear Supplier (Equipment, not the service)––Yes

Practice location

2150 Ne Division St
Suite 101
Gresham, OR 97030-5813

Phone 503-667-2424 · Fax 503-492-3236

Mailing address

2150 Ne Division St
Suite 101
Gresham, OR 97030-5813

Phone 503-667-2424 · Fax 503-492-3236

Authorized official

Greg E Brophy
Optometrist
5036672424

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