Organization
EYEBALL OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL R KELLY L.O. (PRES)
(860) 876-6156
Entity
Organization
Contact information
Practice address
458 TALCOTTVILLE RD, VERNON, CT 06066-4052
(860) 875-6156
(860) 871-3822
Mailing address
458 TALCOTTVILLE RD, VERNON, CT 06066-4052
(860) 875-6156
(860) 871-3822
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1167
CT
Other
Enumeration date
10/06/2006
Last updated
10/05/2007
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