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General NPI Number Information
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NPI Number | 1407926850
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Entity Type | Organization
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Legal Business Name | DRS. LAW AND GONZALEZ
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 797 WOODLAND DR. SUITE 101
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City | STUART
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State | VA
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Zip | 24171
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Country | US
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Telephone | 276-694-7126
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Fax | 276-694-7449
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Provider Business Mailing Address
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Address Line | PO BOX 969
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City | STUART
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State | VA
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Zip | 24171-0969
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Country | US
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Telephone | 276-694-7126
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Fax | 276-694-7449
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TAMMY A. DURHAM
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Credential |
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Telephone | 276-694-7126
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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 | 0618000179
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000924
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License Number State | VA
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