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
3108 NORTH BOUNDRY ROAD, MACDILL, FL 33608
(813) 840-2292
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
OE 1781
FL
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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