| NPI | 1770663866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISA CASSIS Office Manager 304-925-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 12950) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WV 2026-IOD1) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2016-10-11 |