| NPI | 1326422155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL STEVENS Optometrist/Owner 304-727-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV WV-1080-OD) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |