Organization
JACKSONVILLE OPTICAL CO. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY FRANKLIN BUTLER LICENSED OPTICIAN (PRESIDENT)
(910) 353-3827
Entity
Organization
Contact information
Practice address
353 WESTERN BLVD, JACKSONVILLE, NC 28546-6347
(910) 353-3827
(919) 353-0431
Mailing address
353 WESTERN BLVD, JACKSONVILLE, NC 28546-6347
(910) 353-3827
(919) 353-0431
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
#346
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8801908
—
NC
Enumeration date
12/28/2006
Last updated
01/14/2008
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