Organization
G WONETTE OWEN OR ALY GWINN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARISA D ROGERS (OWNER)
(806) 745-7999
Entity
Organization
Contact information
Practice address
2811 S LOOP 289, LUBBOCK, TX 79423-1488
(806) 745-7999
Mailing address
2811 S LOOP 289, LUBBOCK, TX 79423-1488
(806) 745-7999
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
07/30/2007
Last updated
01/25/2008
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