Organization
SOUTHERN OPTICAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES FLOYD BIBB LIC DISP OPTICIAN (PRESIDENT)
(615) 329-1731
Entity
Organization
Contact information
Practice address
1916 PATTERSON ST, SUITE 104, NASHVILLE, TN 37203-2154
(615) 329-1731
(615) 329-9899
Mailing address
1916 PATTERSON ST, SUITE 104, NASHVILLE, TN 37203-2154
(615) 329-1731
(615) 329-9899
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DPO226
TN
Other
Enumeration date
06/21/2007
Last updated
02/11/2008
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