Organization
OPTOMETRIC SPECIALTY GROUP LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDIE RYBA (PRACTICE MANAGER)
(860) 236-1218
Entity
Organization
Contact information
Practice address
77 S MAIN ST, WEST HARTFORD, CT 06107-2404
(860) 236-1218
Mailing address
77 S MAIN ST, WEST HARTFORD, CT 06107-2404
(860) 236-1218
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02448
CT
Other
Enumeration date
10/02/2006
Last updated
03/08/2010
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