Organization
WAL-MART STORE EAST, LP
Active
Other names
Vision Center 30-2176
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE D GENTILE (NPI COORDINATOR)
(316) 788-5580
Entity
Organization
Contact information
Practice address
2144 W INDIANTOWN RD, JUPITER, FL 33458-5810
(561) 746-6422
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
09/29/2006
Last updated
12/06/2024
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