| NPI | 1861571002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH M. BANNON President 304-234-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 797D) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 3766) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-08-05 |