Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-3307
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE D GENTILE (NPI COORDINATOR)
(316) 788-5580
Entity
Organization
Contact information
Practice address
35 MIKE STEWART DR, CRAWFORDVILLE, FL 32327
(850) 926-1560
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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