Organization
JACK RABY OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK W RABY II LDO (OWNER)
(865) 982-5317
Entity
Organization
Contact information
Practice address
343 GILL ST, ALCOA, TN 37701-2415
(865) 982-5317
(865) 982-5935
Mailing address
343 GILL ST, ALCOA, TN 37701-2415
(865) 982-5317
(865) 982-5935
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DPO 446
TN
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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