Organization
DRS. LAW AND GONZALEZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY A. DURHAM (OFFICE MANAGER)
(276) 694-7126
Entity
Organization
Contact information
Practice address
797 WOODLAND DR., SUITE 101, STUART, VA 24171
(276) 694-7126
(276) 694-7449
Mailing address
PO BOX 969, STUART, VA 24171-0969
(276) 694-7126
(276) 694-7449
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618000179
VA
152W00000X
Optometrist
Primary
0618000924
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902643
—
NC
Enumeration date
11/09/2006
Last updated
09/16/2008
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