Organization
1162 MILITARY TRAIL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN MCCORMACK (CHIEF EXECUTIVE OFFICER)
(877) 881-0022
Entity
Organization
Contact information
Practice address
7326 LAKE UNDERHILL RD, ORLANDO, FL 32822-6055
(407) 380-2020
Mailing address
7326 LAKE UNDERHILL RD, ORLANDO, FL 32822-6055
(407) 380-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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