| NPI | 1861629917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D. TROUT Clinic Administrator 304-647-1140 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 156FC0800X Technician/Technologist, Contact Lens | |
| 156FC0801X Technician/Technologist, Contact Lens Fitter | |
| 156FX1101X Technician/Technologist, Ophthalmic Assistant | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |