Organization
EYE GALLEY OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVA MAXINE AGEE (OWNER)
(804) 640-5264
Entity
Organization
Contact information
Practice address
5219 S LABURNUM AVE, RICHMOND, VA 23231-4432
(804) 640-5264
Mailing address
5219 S LABURNUM AVE, RICHMOND, VA 23231-4432
(804) 640-5264
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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