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NPI 1750638755

OrganizationActive

1162 Military Trail LLC

NPI 1750638755 · Optician · Santa Rosa Beach, FL

Provider details

NPI number: 1750638755
Entity type: Organization
Primary specialty: OpticianEye and Vision Services Providers
Authorized official: Galen Grayson, Owner/Medical Director

Practice location

25 Central Square

Santa Rosa Beach, FL 32459

Phone: (888) 264-4989

Fax: (850) 534-3022

More FL providers

Mailing address

25 Central Square

Santa Rosa Beach, FL 32459

Registry dates

Enumerated: 2012-08-08
Last updated: 2012-08-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

1162 Military Trail LLC — NPI 1750638755, Santa Rosa Beach, FL | NPI Central