Organization
WESTSIDE OPTICAL DISPENSARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA ROSENBOHM (OPTICIAN)
(504) 347-8408
Entity
Organization
Contact information
Practice address
4601 1-2 WICHERS DR, MARRERO, LA 70072-3049
(504) 347-8408
(504) 347-9868
Mailing address
4601 1/2 WICHERS DR, MARRERO, LA 70072-3049
(504) 347-8408
(504) 347-9868
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1949296001
LA
Other
Enumeration date
03/05/2007
Last updated
02/29/2008
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