Organization
EDGEWATER EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ANDREW NICHOLAS O.D. (OPTOMETRIST)
(757) 513-5408
Entity
Organization
Contact information
Practice address
4700 KILGORE AVE, HAMPTON, VA 23666-2057
(757) 825-1849
(757) 827-3261
Mailing address
4700 KILGORE AVE, HAMPTON, VA 23666-2057
(757) 825-1849
(757) 827-3261
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001947
VA
Other
Enumeration date
06/06/2012
Last updated
09/19/2012
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