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General NPI Number Information
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NPI Number | 1669637179
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Entity Type | Organization
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Legal Business Name | RANSON OPTICAL CENTER
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 217 OAK LEE DR STE 12B
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City | RANSON
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State | WV
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Zip | 25438-4866
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Country | US
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Telephone | 304-725-8866
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Fax | 304-725-8874
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Provider Business Mailing Address
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Address Line | 217 OAK LEE DR STE 12B
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City | RANSON
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State | WV
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Zip | 25438-4866
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Country | US
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Telephone | 304-725-8866
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Fax | 304-725-8874
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RHEA LEIGH PRUITT
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Credential |
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Telephone | 304-725-8866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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