Organization
GWA OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA GRIFFITH (VP OF MANAGED VISION CLAIMS)
(516) 292-4137
Entity
Organization
Contact information
Practice address
1554 E 55TH ST, CHICAGO, IL 60615-5550
(773) 667-1177
(773) 347-0266
Mailing address
3601 SW 160TH AVE STE 400, MIRAMAR, FL 33027-6312
(305) 557-9004
(855) 881-9434
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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