Facts
- Status
- A
- Credential
- Optician
- Type
- Individual
- Enumeration date
- 2016-02-02
- Last updated
- 2016-02-02
Specialties
Licenses
- License VA
- 1101003815
Location
- Practice location
- 203 S LOCUST ST, SUITE B
- City
- FLOYD VA
- Postal code
- 240912505
- Phone
- 540-808-5123
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.