Opticlub Express, Inc.

NPI #1801381819 in Pace, Florida

Provider Information

NPI Number: 1801381819
Entity Type: Organization
Organization Name: Opticlub Express, Inc.
Primary Specialty: Optometrist
Enumeration Date: Jun 22, 2018
Last Updated: Dec 28, 2019

Practice Location

Address: 4954 HIGHWAY 90
City: Pace
State: Florida
ZIP Code: 32571-1413
Phone: (850) 910-4840

Authorized Official

Name: DR. ANDREW DAVID BURTCHELL, OD
Title: PRESIDENT/DIRECTOR
Phone: (850) 910-4840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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