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General NPI Number Information
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NPI Number | 1487218822
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Entity Type | Organization
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Legal Business Name | GREENBRIER EYECARE LLC
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 1316 GREENBRIER PKWY
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City | CHESAPEAKE
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State | VA
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Zip | 23320-0605
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Country | US
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Telephone | 757-548-2102
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Fax |
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Provider Business Mailing Address
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Address Line | 128 RUNAWAY BAY DR APT 110
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-8147
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Country | US
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Telephone | 757-286-6844
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JULIE A RYBARCZYK
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Credential | O.D.
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Telephone | 757-286-6844
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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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