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General NPI Number Information
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NPI Number | 1063513471
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Entity Type | Organization
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Legal Business Name | ABINGDON OPTICIANS LTD
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 276 W MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-2749
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Country | US
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Telephone | 276-628-9943
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Fax | 276-623-1232
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Provider Business Mailing Address
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Address Line | 276 W MAIN ST PO BIX 713
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City | ABINGDON
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State | VA
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Zip | 24210-2749
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Country | US
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Telephone | 276-628-9943
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Fax | 276-623-1232
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Authorized Official
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Title or Position | LICENSED OPTICIAN
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Name | MS. CHRISTINE POTTER DAVIDSON
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Credential | D.O.
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Telephone | 276-628-9943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1101001373
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License Number State | VA
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