Organization Name: | ROSSER OPT LTD |
NPI Number: | 1003010323 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIE M ROSSER (OPTICIAN OWNER) |
Mailing Address: | 150 Strawberry Plains Rd Ste B Williamsburg |
State: | VA US |
Postal Code: | 231883408 |
Phone Number: | 7572202020 |
Fax Number: | 7572201340 |
NPI Enumeration Date: | 06/12/2007 |
NPI Last Update Date: | 03/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1101000404 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |