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Organization

MARKET PLAZA OPTICAL COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH KIRBY (OPTICAL MANAGER OWNER)
(910) 799-5161
Entity
Organization

Contact information

Practice address
31 S KERR AVE, WILMINGTON, NC 28403-1416
(910) 799-5161
Mailing address
31 S KERR AVE, WILMINGTON, NC 28403-1416
(910) 799-5161

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
272
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8801661
NC
Enumeration date
03/02/2007
Last updated
06/16/2008
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