| NPI | 1073549598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD FAROOQ ANWAR Billing Office 304-845-0908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 000605) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2012-04-10 |