Organization
TOTAL EYE OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY W. CHURCH O.D. (OWNER)
(540) 825-8220
Entity
Organization
Contact information
Practice address
15189 MONTANUS DRIVE, CULPEPER, VA 22701-1679
(540) 825-8220
(540) 825-8675
Mailing address
15189 MONTANUS DRIVE, CULPEPER, VA 22701-1679
(540) 825-8220
(540) 825-8675
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000722
VA
Other
Enumeration date
10/09/2009
Last updated
07/24/2012
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