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General NPI Number Information
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NPI Number | 1336268903
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Entity Type | Organization
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Legal Business Name | 1 HOUR OPTICAL P C
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2115 WINDSOR SPRING RD SUITE 23
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City | AUGUSTA
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State | GA
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Zip | 30906-4855
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Country | US
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Telephone | 706-793-6211
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Fax | 706-793-6318
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Provider Business Mailing Address
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Address Line | 2115 WINDSOR SPRING RD SUITE 23
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City | AUGUSTA
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State | GA
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Zip | 30906-4855
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Country | US
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Telephone | 706-793-6211
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Fax | 706-793-6318
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Authorized Official
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Title or Position | PRESIDENT OPTOMETRIST
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Name | DR. GARY G CROOK
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Credential | OD
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Telephone | 706-793-6211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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