| NPI | 1255416137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL COLLEEN VAN HORN Owner/President 304-366-3830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 853-OD) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-08-18 |