Organization
CUSTOM CONTACT LENS
Active
Other names
Custom Optics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTODOULOS MICHAEL PETRAS M.D. (SOBIC)
(804) 320-0078
Entity
Organization
Contact information
Practice address
107 TWINRIDGE LN, RICHMOND, VA 23235-5241
(804) 320-0078
Mailing address
107 TWINRIDGE LN, RICHMOND, VA 23235-5241
(804) 320-0078
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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