Susan Grayson

Individual provider Active NPI Optician · Demopolis, AL

NPI 1932271707 · NPPES record last updated Jun 10, 2008

Key facts

NPI
1932271707
Entity type
Individual (NPI type 1)
Primary specialty
Optician 156FX1800X
Practice address
111 W Washington St
Demopolis, AL 36732-2043
Phone
(334) 289-4749
Fax
(334) 287-2197
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Yes

Addresses

Primary practice location

111 W Washington St
Demopolis, AL 36732-2043

Mailing address

111 W Washington St
Demopolis, AL 36732-2043
Phone (334) 289-4749

Other providers in Demopolis, AL

All providers in Demopolis, AL · Optician in Alabama

Sources for this page

Verify at the official NPI Registry.