Organization
V: OPTICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SOMPHAVANH VINAVONG (OWNER/PRESIDENT)
(229) 888-3772
Entity
Organization
Contact information
Practice address
2234 PALMYRA RD, ALBANY, GA 31701-1322
(229) 888-3772
(229) 888-3688
Mailing address
2234 PALMYRA RD, ALBANY, GA 31701-1322
(229) 888-3772
(229) 888-3688
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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