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General NPI Number Information
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NPI Number | 1881808749
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Entity Type | Organization
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Legal Business Name | OPTOMETRIC ASSOCIATES
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 3405 CHANDLER MOUNTAIN ROAD
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City | LYNCHBURG
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State | VA
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Zip | 24502
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Country | US
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Telephone | 434-239-8888
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Fax | 434-239-4536
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Provider Business Mailing Address
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Address Line | 3405 CHANDLER MOUNTAIN ROAD
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City | LYNCHBURG
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State | VA
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Zip | 24502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST PART OWNER
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Name | DR. JAMES ZIMMERMAN
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Credential | O.D.
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Telephone | 908-685-0033
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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 | 0601001000
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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 | 0601000680
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License Number State | VA
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