Organization
STARCHVICK OPTICAL INC
Active
Other names
Advanced Vision Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD ROBERT STARCHVICK O.D. (PRESIDENT)
(541) 779-1392
Entity
Organization
Contact information
Practice address
1251 E MCANDREWS RD, SUITE 100, MEDFORD, OR 97504-6497
(541) 779-1392
(541) 779-6531
Mailing address
1251 E MCANDREWS RD, SUITE 100, MEDFORD, OR 97504-6497
(541) 779-1392
(541) 779-6531
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
1563ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212666
EYEMED
OR
05
—
271176
—
OR
Enumeration date
12/14/2006
Last updated
04/20/2008
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