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General NPI Number Information
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NPI Number | 1962757344
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Entity Type | Organization
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Legal Business Name | GILICH ENTERPRISES, LLC
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 2318 PASS ROAD SUITE 1
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City | BILOXI
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State | MS
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Zip | 39531-4044
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Country | US
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Telephone | 228-967-7813
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Fax | 228-967-7814
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Provider Business Mailing Address
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Address Line | 2318 PASS ROAD SUITE 1
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City | BILOXI
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State | MS
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Zip | 39531-4044
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Country | US
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Telephone | 228-967-7813
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Fax | 228-967-7814
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHNEEN E GILICH
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Credential | O.D.
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Telephone | 602-628-3464
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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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