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General NPI Number Information
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NPI Number | 1316419773
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Entity Type | Organization
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Legal Business Name | CENTER FOR VISION DEVELOPMENT AND REHABILITATION
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 164 W MAIN ST STE B
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City | NEW MARKET
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State | MD
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Zip | 21774-6279
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Country | US
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Telephone | 301-865-1800
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Fax | 301-865-1973
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Provider Business Mailing Address
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Address Line | 164 W MAIN ST STE B
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City | NEW MARKET
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State | MD
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Zip | 21774-6279
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Country | US
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Telephone | 301-865-1800
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Fax | 301-865-1973
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | MARSHA DAVIS BENSHIR
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Credential | OD
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Telephone | 301-865-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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