Organization
GANG RISK INTERVENTION PROJECT, INCORPORATED
Active
Other names
GRIP Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN BENNETT FAST SR. (PRESIDENT)
(575) 534-2020
Entity
Organization
Contact information
Practice address
212 E 12TH ST, SILVER CITY, NM 88061-6408
(575) 388-2443
Mailing address
212 E 12TH ST, SILVER CITY, NM 88061-6408
(575) 388-2443
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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