Organization
WALLS VISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER THOMAS WALLS O.D. (OPTOMETRIST)
(662) 226-0042
Entity
Organization
Contact information
Practice address
1655 SUNSET DR, GRENADA, MS 38901-4061
(662) 226-0042
(662) 226-4696
Mailing address
1655 SUNSET DR, GRENADA, MS 38901-4061
(662) 226-0042
(662) 226-4696
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
629
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02473861
—
MS
Enumeration date
11/16/2006
Last updated
11/03/2010
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