Wal-Mart Stores East, LP

NPI #1467517102 in Ooltewah, Tennessee

Provider Information

NPI Number
1467517102
Entity Type
Organization
Organization Name
Wal-Mart Stores East, LP
Primary Specialty
Technician/Technologist - Optician
Enumeration Date
Dec 22, 2006
Last Updated
Dec 22, 2021

Practice Location

Address
5588 LITTLE DEBBIE PKWY
ZIP Code
37363-4356
Phone
(423) 238-1069

Authorized Official

Name
BJ RICE
Title
PROVIDER ENROLLMENT SPECIALIST
Phone
(479) 277-9835

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier
Technician/Technologist - OpticianOptician

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