Organization
ADVANCED EYECARE, LLC
Active
Other names
Granger Eye Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY J GRANGER OD (OPTOMETRIST, CEO)
(337) 451-4511
Entity
Organization
Contact information
Practice address
107 CENTRE SARCELLE BLVD., SUITE 704, YOUNGSVILLE, LA 70592
(337) 451-4511
(337) 857-6044
Mailing address
107 CENTRE SARCELLE BLVD., SUITE 704, YOUNGSVILLE, LA 70592
(337) 451-4511
(337) 857-6044
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1611-644T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2167626
—
LA
Enumeration date
09/13/2013
Last updated
12/16/2014
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