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Organization
OPTICLUB EXPRESS, INC.
Active
Organization
OPTICLUB EXPRESS, INC.
Active
Other names
Opticlub Express
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW DAVID BURTCHELL OD (PRESIDENT/DIRECTOR)
(850) 910-4840
Entity
Organization
Contact information
Practice address
4954 HIGHWAY 90, PACE, FL 32571-1413
(850) 910-4840
(850) 254-2970
Mailing address
4954 HIGHWAY 90, PACE, FL 32571-1413
(850) 910-4840
(850) 254-2970
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/22/2018
Last updated
12/28/2019
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