Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician |
| NPI Number | 1376007419 |
| LBN Legal business name | GREEN VALLEY OPTICAL, LLC |
| Authorized official | BENJAMIN SALOIS - (MEMBER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/23/2019 |
| Last updated | 01/23/2019 - About 7 years ago |
| Identifiers | n/a |
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