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General NPI Number Information
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NPI Number | 1467496281
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Entity Type | Organization
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Legal Business Name | DANVILLE OPTICAL CENTER
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 RISON ST
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City | DANVILLE
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State | VA
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Zip | 24541-2458
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Country | US
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Telephone | 434-793-5500
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Fax | 434-793-1157
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Provider Business Mailing Address
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Address Line | 515 RISON ST
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City | DANVILLE
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State | VA
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Zip | 24541-2458
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Country | US
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Telephone | 434-793-5500
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Fax | 434-793-1157
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Authorized Official
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Title or Position | VP/SECRETARY-ADMINISTRATOR
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Name | MS. JUDITH L COBBLE
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Credential |
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Telephone | 434-793-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1101000880
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License Number State | VA
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