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Organization
TAYLOR CREEK OPTICAL INC
Active
Organization
TAYLOR CREEK OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM EDWARD PALMER (PRESIDENT)
(772) 468-0008
Entity
Organization
Contact information
Practice address
104 N 2ND ST, FORT PIERCE, FL 34950
(772) 468-0008
(772) 468-6628
Mailing address
104 N 2ND ST, FORT PIERCE, FL 34950-4403
(772) 468-0008
(772) 468-6628
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
DO3798
FL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
OE480
FL
Other
Enumeration date
01/10/2007
Last updated
08/17/2018
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