Organization
BLUE RIDGE OPTICAL
Active
Parent organization
BLUE RIDGE OPTICAL, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUE RIDGE OPTICAL, INC.
Authorized official
CHRISTOPHER M CLARK LICENSED OPTICIAN (MANAGER/ CORPORATE SECRETARY)
(540) 776-9722
Entity
Organization
Contact information
Practice address
110 PROFESSIONAL PARK DR SE, SUITE 6, BLACKSBURG, VA 24060-6735
(540) 552-4588
(540) 552-4612
Mailing address
110 PROFESSIONAL PARK DR SE, SUITE 6, BLACKSBURG, VA 24060-6735
(540) 552-4588
(540) 552-4612
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
11011002026
VA
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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