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General NPI Number Information
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NPI Number | 1275760001
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Entity Type | Organization
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Legal Business Name | DR. KENT B MCQUAIN & ASSOCIATES-OPTOMETRISTS, P.C.
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 5220 GEORGE WASHINGTON MEM HWY
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City | GRAFTON
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State | VA
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Zip | 23692-2759
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Country | US
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Telephone | 757-898-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 5220 GEORGE WASHINGTON MEM HWY
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City | GRAFTON
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State | VA
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Zip | 23692-2759
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Country | US
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Telephone | 757-898-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENT B MCQUAIN
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Credential |
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Telephone | 757-898-1000
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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 | 0618000792
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License Number State | VA
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