Organization
JAN'S OPTICAL SHOP OF CRYSTAL RIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY A CHRISTOPHER (MANAGERING MEMBER)
(352) 795-7228
Entity
Organization
Contact information
Practice address
597 SE US HIGHWAY 19, CRYSTAL RIVER, FL 34429-4807
(352) 795-7228
Mailing address
597 SE US HIGHWAY 19, CRYSTAL RIVER, FL 34429-4807
(352) 795-7228
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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