Organization
ETHAN ALLEN OPTICAL
Active
Organization
ETHAN ALLEN OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS MURTHA (OPTICIAN)
(802) 658-6700
Entity
Organization
Contact information
Practice address
1127 NORTH AVE STE 34, BURLINGTON, VT 05408-2756
(802) 658-6700
Mailing address
1127 NORTH AVE STE 34, BURLINGTON, VT 05408-2756
(802) 658-6700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0280000210
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006612
—
VT
Enumeration date
01/16/2008
Last updated
01/16/2008
Update your record
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