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NPI Profile for OPTICAL OUTLET INC IV in PORT SAINT LUCIE, FL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician |
| NPI Number | 1104046267 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/30/2007 | |
| Last updated | 08/22/2020 - About 6 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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OPTICAL OUTLET INC IV
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OPTICAL OUTLET INC IV