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Organization

OPTIQUE UNIQUE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEITH BARRY SMITH OPTICIAN (OPTICIAN)
(321) 729-4340
Entity
Organization

Contact information

Practice address
880 N MIRAMAR AVE, INDIALANTIC, FL 32903-3054
(321) 729-4340
Mailing address
880 N MIRAMAR AVE, INDIALANTIC, FL 32903-3054
(321) 729-4340

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
2197
FL

Other

Enumeration date
02/05/2008
Last updated
03/10/2008
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