NPI 1609312537

Provision LLC

Organisation Optometrist South Charleston, WV

Practice location

Address: 306 Southridge Blvd, South Charleston, WV 25309-9434
Phone: (304) 744-4017
Fax: (304) 744-4018

Authorised official

Name: David Beecher
Title: Owner
Phone: (304) 744-4017

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2030-IOD (WV)

Other Optometrist providers in West Virginia →

Registry record

NPI: 1609312537
Entity type: Organization
NPI issued: 17 Jan 2017
Record last updated: 19 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.