Organization
SHENANDOAH OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A MOORE OPTICIAN (PRESIDENT)
(540) 667-2220
Entity
Organization
Contact information
Practice address
230 SHENANDOAH ST, WOODSTOCK, VA 22664-1051
(540) 459-8313
(540) 459-9452
Mailing address
230 SHENANDOAH ST, WOODSTOCK, VA 22664-1051
(540) 459-8313
(540) 459-9452
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1101001190
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009280758
—
VA
Enumeration date
10/24/2005
Last updated
08/27/2008
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