Organization
ROUTE 33 EYE CARE & OPTICAL BOUTIQUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY M COOPER O.D. (OWNER/OPTOMETRIST)
(954) 298-9913
Entity
Organization
Contact information
Practice address
1013 S TALBOT ST, SAINT MICHAELS, MD 21663-2637
(954) 298-9913
Mailing address
510 TENANT CIR, SAINT MICHAELS, MD 21663-2873
(954) 298-9913
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
06/05/2023
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