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Organization

REEVES MOBILE OD TN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANDY AMMON (CFO)
(502) 244-2441
Entity
Organization

Contact information

Practice address
105 E MARKET ST, SOMERVILLE, TN 38068-1407
(502) 244-2441
Mailing address
12910 SHELBYVILLE RD STE 300, LOUISVILLE, KY 40243-2404
(502) 244-2441
(502) 254-4069

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
03/20/2018
Last updated
03/20/2018
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