Individual
CHARLES ROBERT KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
WALMART VISION 979 ROUTE 1 SOUTH, NORTH BRUNSWICK, NJ 08902-1902
(732) 545-0435
(732) 545-0629
Mailing address
979 ROUTE 1, NORTH BRUNSWICK, NJ 08902-2712
(732) 545-0435
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
TD3694
NJ
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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