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General NPI Number Information
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NPI Number | 1356497317
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Entity Type | Organization
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Legal Business Name | VIENNA OPTICAL CO., INC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 301 MAPLE AVE W STE A
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City | VIENNA
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State | VA
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Zip | 22180-4301
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Country | US
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Telephone | 703-938-6214
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Fax | 703-938-9011
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Provider Business Mailing Address
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Address Line | 301 MAPLE AVE W STE A
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City | VIENNA
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State | VA
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Zip | 22180-4301
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Country | US
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Telephone | 703-938-6214
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Fax | 703-938-9011
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NORMAN T. ABSHIRE
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Credential | LICENSED OPTICIAN
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Telephone | 703-938-6214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 1066
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License Number State | VA
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