| Organization Name: | TRI-CITY OPTICIANS, LLC |
| NPI Number: | 1346453966 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANNON H LOONEY (OPTICIAN) |
| Mailing Address: | 5057 Dickenson Hwy Clintwood |
| State: | VA US |
| Postal Code: | 242286078 |
| Phone Number: | 2769264234 |
| Fax Number: | 2769264375 |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 02/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 003309 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |