Organization Name: | VA OPTICIANS INC |
NPI Number: | 1013005222 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ISAAC W KING (OWNER) |
Mailing Address: | 3324 Halifax Rd South Boston |
State: | VA US |
Postal Code: | 24592 |
Phone Number: | 4345755166 |
Fax Number: | 4345755166 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1101001239 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |