Organization
E WINGO & P COLCHISKI PTR
Active
Other names
EyeCare Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PENELOPE COLCHISKI WINGO (COOWNER-MANAGER)
(352) 629-2422
Entity
Organization
Contact information
Practice address
2437 E FORT KING ST, OCALA, FL 34471-2558
(352) 629-2422
(352) 732-0177
Mailing address
2437 E FORT KING ST, OCALA, FL 34471-2558
(352) 629-2422
(352) 732-0177
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
ME0028326
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057222500
—
FL
Enumeration date
01/12/2007
Last updated
06/18/2008
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