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Organization

THE OPTICAL SHOP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. WANDA GAIL LAGRONE L.D.O. (OWNER/OPTICIAN)
(912) 354-6445
Entity
Organization

Contact information

Practice address
712 E 69TH ST, SAVANNAH, GA 31405-4716
(912) 354-6445
(912) 354-3393
Mailing address
712 E 69TH ST, SAVANNAH, GA 31405-4716
(912) 354-6445
(912) 354-3393

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1041
GA

Other

Enumeration date
02/05/2008
Last updated
10/08/2009
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