Organization
OPTICAL GALLERY LLC
Active
Other names
OPTICAL GALLERY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERL;Y A RAYMOND OD (OPTOMETRIST AND OWNER)
(402) 470-0074
Entity
Organization
Contact information
Practice address
1550 S CODDINGTON AVE, SUITE V, LINCOLN, NE 68522-4402
(402) 470-0074
(402) 261-5855
Mailing address
1550 S CODDINGTON AVE, SUITE V, LINCOLN, NE 68522-4402
(402) 470-0074
(402) 261-5855
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025701100
—
NE
Enumeration date
04/15/2009
Last updated
03/29/2012
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