NPI | 1639573264 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTY BRAXTON MOORE Optometrist 304-369-9100 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: WV 1064-OD) |
Enumeration Date | 2014-10-10 |
Last Update Date | 2014-10-10 |