Organization
EASTGATE VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARSHA LYNN ROACH OPTICIAN (OPTICIAN)
(386) 328-2008
Entity
Organization
Contact information
Practice address
164 HWY 17 SOUTH, SUITE 12-C EASTGATE VISION CENTER, EAST PALATKA, FL 32131
(386) 328-2008
(386) 328-2008
Mailing address
164 HWY 17 SOUTH, SUITE 12-C, EAST PALATKA, FL 32131
(386) 328-2008
(386) 328-2008
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D01128
FL
Other
Enumeration date
03/19/2008
Last updated
09/24/2010
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