| NPI | 1275994329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SHAW Optician/Owner 540-808-5123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: VA 1101003815) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |