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General NPI Number Information
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NPI Number | 1164674289
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Entity Type | Organization
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Legal Business Name | KARL C. SALIBA, O.D., PC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 2222 ELECTRIC ROAD, S.W. SUITE 201
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City | ROANOKE
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State | VA
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Zip | 24018-2300
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Country | US
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Telephone | 540-774-8007
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Fax | 540-774-4530
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Provider Business Mailing Address
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Address Line | 2222 ELECTRIC ROAD, S.W. SUITE 201
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City | ROANOKE
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State | VA
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Zip | 24018-2300
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Country | US
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Telephone | 540-774-8007
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Fax | 540-774-4530
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Authorized Official
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Title or Position | OWNER
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Name | KARL C SALIBA
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Credential | OD
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Telephone | 540-774-8007
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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 | 0618000122
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License Number State | VA
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