Organization
SUNLAND OPTICAL CO., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WILLIAM MUSGRAVE (CFO)
(915) 591-9483
Entity
Organization
Contact information
Practice address
2725 LEMAY BLVD, ELLSWORTH AFB, SD 57706-4868
(605) 923-2159
Mailing address
1156 BARRANCA DR, EL PASO, TX 79935-5002
(915) 591-9483
(915) 225-0698
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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