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Organization

RIVERSIDE OPTICAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ERNES VAN JOHNSON M.D. (PHYSICIAN OWNER)
(205) 556-4440
Entity
Organization

Contact information

Practice address
535 JACK WARNER PKWY NE STE B2, TUSCALOOSA, AL 35404-5715
(205) 554-0107
(205) 554-0198
Mailing address
535 JACK WARNER PKWY NE STE B2, TUSCALOOSA, AL 35404-5715
(205) 554-0107
(205) 554-0198

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
11/09/2006
Last updated
05/03/2016
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