| NPI | 1629130810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY LEE WHITTINGTON Optometrist 304-342-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-02-01 |