Organization
CUSTOM OPTICAL OF FONDREN LLC
Active
Other names
Custom Optical Of Fondren LLC, Custom Optical Of Fondren LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA HAMMONS (OWNER/OPTICIAN)
(601) 362-6675
Entity
Organization
Contact information
Practice address
661 DULING AVE, JACKSON, MS 39216-4008
(601) 362-6675
(601) 362-5767
Mailing address
661 DULING AVE, JACKSON, MS 39216-4008
(601) 362-6675
(601) 362-5767
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/04/2008
Last updated
04/29/2022
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