NPI 1720292865

Custom Eyes Optical

Organisation Optometrist Reisterstown, MD

Practice location

Address: 11977 Reisterstown Rd, Reisterstown, MD 21136-3030
Phone: (410) 833-1910
Fax: (410) 833-1911

Authorised official

Name: Fred Havelock
Title: Pres
Phone: (410) 833-1910

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence TA0666 (MD)

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Registry record

NPI: 1720292865
Entity type: Organization
NPI issued: 9 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.