| NPI | 1265837652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WEINBERGER CFO 304-525-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |