NPI Profile for SAMS CLUB OPTICAL in PORT SAINT LUCIE, FL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician | |
Eyewear Supplier |
332H00000X | 87 | All Other Suppliers |
| NPI # | 1467636449 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/26/2007 | |
| Last updated | 12/26/2007 - About 18 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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SAM'S CLUB OPTICAL
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