| NPI | 1164649505 |
|---|---|
| Doing Business As | OPTICAL SHOPPE OF JAX |
| Entity Type | Organization |
| Authorized Contact | SANDRA L CRAIG Owner 904-730-3388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-03-18 |