Organization
ADVANCED OPTIX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIANA GROVE O.D. (SOLE MEMBER)
(773) 663-6882
Entity
Organization
Contact information
Practice address
1310 E 79TH AVE, MERRILLVILLE, IN 46410-5768
(219) 641-6403
Mailing address
2924 E 62ND PL, HOBART, IN 46342-6440
(773) 663-6882
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003481A
IN
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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