Organization
1162 MILITARY TRAIL LLC
Active
Other names
The Eye Gallery-Destin Commons
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GALEN GRAYSON M.D. (OWNER/MEDICAL DIRECTOR)
(704) 295-0001
Entity
Organization
Contact information
Practice address
4143 LEGENDARY DR, DESTIN, FL 32541-5393
(850) 650-4370
(850) 650-0193
Mailing address
4143 LEGENDARY DR, DESTIN, FL 32541-5393
(850) 650-4370
(850) 650-0193
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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