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General NPI Number Information
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NPI Number | 1104923242
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Entity Type | Organization
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Legal Business Name | DR. TRACY SCHEIBE, OPTOMETRIST, P.C.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4524 CHALLENGER AVE
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City | ROANOKE
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State | VA
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Zip | 24012-7028
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Country | US
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Telephone | 540-977-6022
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Fax | 540-977-6023
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Provider Business Mailing Address
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Address Line | 4524 CHALLENGER AVE
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City | ROANOKE
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State | VA
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Zip | 24012-7028
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Country | US
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Telephone | 540-977-6022
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Fax | 540-977-6023
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | DR. TRACY SCHEIBE
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Credential | O.D.
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Telephone | 540-977-6022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000916
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License Number State | VA
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