Organization
MONTGOMERY OPTICAL CENTER INC.
Active
Other names
2020 Optical Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANIELLE R FULLER (MANAGER)
(334) 281-5011
Entity
Organization
Contact information
Practice address
2020 NORMANDIE DR, MONTGOMERY, AL 36111-2734
(334) 281-5011
Mailing address
2020 NORMANDIE DR, MONTGOMERY, AL 36111-2734
(334) 281-5011
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0001701
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59221
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/10/2006
Last updated
08/22/2020
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