Organization
MRG INC
Active
Other names
Garrys Opticians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL RICHARD GRAVALIN ABOC OPTICIAN (OWNER MANAGER)
(701) 232-1161
Entity
Organization
Contact information
Practice address
2810 NORTH BROADWAY, FARGO, ND 58102-1420
(701) 232-1161
Mailing address
2810 NORTH BROADWAY, FARGO, ND 58102-1420
(701) 232-1161
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
11/13/2006
Last updated
08/22/2020
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