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COLDWATER VISION CENTER LLC

Eye and Vision Services Providers Optometrist

Provider NPI: 1003952383

Organization Information:
Organization Name:  COLDWATER VISION CENTER LLC
Organization is not Subpart
Authorized Official:  KRISTOPHER ALAN MAY  OWNER  662-622-5173

Practice Location:
412 CENTRAL AVENUE  COLDWATER, MS 38618 US
Tel: 662-622-5173  Fax: 662-622-5590

Business Mailing Address:
PO BOX 486  COLDWATER, MS 38618-0486 US
Tel: 662-622-5173  Fax: 662-622-5590

NPI Information:
NPI: 1003952383
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist

Other Provider Identifiers:

IssuerNumberStateType
08152004MS05



American Medical Association 2012 taxonomy code information

Code: 152W00000X

Type:

Classification:



Definition:



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