Organization
COLISEUM EYEWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BILLIE T. LITWIN (PRESIDENT)
(336) 757-1120
Entity
Organization
Contact information
Practice address
611 COLISEUM DR, WINSTON SALEM, NC 27106-5310
(336) 397-7200
(336) 757-1202
Mailing address
611 COLISEUM DR, WINSTON SALEM, NC 27106-5310
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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