Organization
20-20 OPTICAL
Active
Organization
20-20 OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY R FERGUSON LDO, PH.D. (CO-OWNER)
(865) 453-2025
Entity
Organization
Contact information
Practice address
120 BRUCE ST, SEVIERVILLE, TN 37862-3558
(865) 453-2025
(865) 429-1240
Mailing address
PO BOX 5170, SEVIERVILLE, TN 37864-5170
(865) 453-2025
(865) 429-1240
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
DPO0000000400
TN
Other
Enumeration date
11/22/2006
Last updated
08/22/2020
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