| NPI | 1861477051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD W SHELL Optician 757-934-2422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: VA 1101000541) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: VA 1101001778) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-08-22 |