Organization
GEM OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL ANN PETERSEN O.D. (OWNER)
(301) 918-0095
Entity
Organization
Contact information
Practice address
6603 RIVERDALE RD, RIVERDALE, MD 20737-2908
(301) 918-0095
(301) 918-0097
Mailing address
6603 RIVERDALE RD, RIVERDALE, MD 20737-2908
(301) 918-0095
(301) 918-0097
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1874
MD
Other
Enumeration date
10/03/2007
Last updated
06/13/2011
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