Magnolia Place Eyecare LLC
Optometrist in Tallassee, AL. Organization (NPI-2).
NPI number1922767136
StatusActive
Last updated in NPPESDec 15, 2021
Details
- NPI
- 1922767136
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Place Eyecare LLC
- Organization subpart
- No
- Enumeration date
- Dec 15, 2021
- Certification date
- Dec 15, 2021
- Last updated
- Dec 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Other names
- Dr. Paris Mullins, Jr. O.D. (Former Legal Business Name)
Practice location
1609 Gilmer AveTallassee, AL 36078-2343
Phone 334-283-6535 · Fax 334-283-5996
Mailing address
1609 Gilmer AveTallassee, AL 36078-2343
Phone 334-283-6535 · Fax 334-283-5996
Authorized official
Paris Mullins
Doctor/Owner
3342836535
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