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General NPI Number Information
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NPI Number | 1700178266
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Entity Type | Organization
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Legal Business Name | Z&B OPTICAL, IND
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 23 EAST SQ
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City | WASHINGTON
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State | GA
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Zip | 30673-1517
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Country | US
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Telephone | 706-678-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 23 EAST SQ
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City | WASHINGTON
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State | GA
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Zip | 30673-1517
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Country | US
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Telephone | 706-678-4880
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Fax |
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Authorized Official
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Title or Position | OPTICIAN/OFFICE MANAGER
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Name | SHERRY S HUDSON
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Credential | LDO
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Telephone | 706-468-4880
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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 | 1302
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License Number State | GA
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