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Organization

PROFESSIONAL OPTICIANS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY C MAXWELL (OWNER/OPTICIAN)
(252) 441-6353
Entity
Organization

Contact information

Practice address
5000 S CROATAN HWY, NAGS HEAD, NC 27959-8500
(252) 441-6353
Mailing address
PO BOX 1088, NAGS HEAD, NC 27959-1088
(252) 441-6353

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1048
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8802047
NC
Enumeration date
04/05/2010
Last updated
04/05/2010
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