| NPI | 1467622605 |
|---|---|
| Other Name | CUSTOM OPTICAL OF FONDREN LLC |
| Doing Business As | CUSTOM OPTICAL OF FONDREN LLC |
| Entity Type | Organization |
| Authorized Contact | PATRICIA HAMMONS Owner/Optician 601-362-6675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2022-04-29 |