Organization
OPTICAL SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BONNY (OFFICE MANAGER)
(301) 588-1177
Entity
Organization
Contact information
Practice address
8630 FENTON ST, SUITE 123, SILVER SPRING, MD 20910-3806
(301) 589-7732
(301) 589-5245
Mailing address
8630 FENTON ST, SUITE 123, SILVER SPRING, MD 20910-3806
(301) 589-7732
(301) 589-5245
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
01/08/2007
Last updated
06/18/2008
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