Mel Rockwall LLC

NPI #1346887304 in Mansfield, Texas

Provider Information

NPI Number
1346887304
Entity Type
Organization
Organization Name
Mel Rockwall LLC
Primary Specialty
Eyewear Supplier
Enumeration Date
Dec 9, 2019
Last Updated
Feb 19, 2021

Practice Location

Address
1701 E BROAD ST STE 109
State
Texas
ZIP Code
76063-4349
Phone
(682) 341-3921

Authorized Official

Name
JACKIE BENNETT
Title
CREDENTIALING SUPERVISOR
Phone
(561) 433-6009

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier

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