Organization
CLARKSBURG EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRVING GAN O.D. (OWNER)
(301) 972-3937
Entity
Organization
Contact information
Practice address
23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
(301) 972-3937
Mailing address
23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
(301) 972-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1469
MD
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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