NPI 1003580762

Ian Matthew Cheslock

Practitioner Optometrist Longview, WA

Practice location

Address: 950 11th Ave, Longview, WA 98632-2504
Phone: (360) 577-1500
Fax: (360) 425-0735

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 61169322 (WA)

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Registry record

NPI: 1003580762
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Aug 2021
Record last updated: 5 Aug 2021

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.