Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician |
| NPI # | 1942528427 |
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| LBN Legal business name | NEW KENT OPTICAL | ||||
| Authorized official | JACQUELINE KOWAL - (OWNER/OPTICIAN) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 05/10/2010 | ||||
| Last updated | 05/10/2010 - About 16 years ago | ||||
| Identifiers |
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| JACQUELINE M KOWAL, R.O. 2520 NEW KENT HIGHWAY QUINTON, VA |
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