WESTSIDE OPTICAL SHOPLLC NPI 1962775817

NPI Information

WESTSIDE OPTICAL SHOP,LLC is an eyewear supplier in Spartanburg, SC. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. WESTSIDE OPTICAL SHOP,LLC NPI is 1962775817. The provider is registered as an organization entity type.

The provider's business location address is:

1413 JOHN B WHITE SR BLVD
SUITE A
SPARTANBURG, SC
ZIP 29306-995
Phone: (864) 587-1039
Fax: (864) 587-1936

The provider's authorized official is Lawrence Edmund Roel .
The authorized official title is Owner/provider and has the following contact phone number (864) 542-1308.

The enumeration date for this NPI number is 2/22/2012 and was last updated on 5/31/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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