| NPI | 1134904519 |
|---|---|
| Former Legal Business Name | ALPHA OPTICAL GLEN MILLS, LLC |
| Entity Type | Organization |
| Authorized Contact | GRETCHEN J BREWER President 267-481-2360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-08-25 |