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General NPI Number Information
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NPI Number | 1679732127
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Entity Type | Organization
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Legal Business Name | COHRON FAMILY OPTOMETRIC SERVICES INC
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 221 W G L SMITH ST
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City | MORGANTOWN
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State | KY
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Zip | 42261-8602
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Country | US
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Telephone | 270-526-6800
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Fax | 270-526-5462
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Provider Business Mailing Address
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Address Line | 221 W G L SMITH ST
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City | MORGANTOWN
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State | KY
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Zip | 42261-8602
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Country | US
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Telephone | 270-526-6800
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Fax | 270-526-5462
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Authorized Official
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Title or Position | OWNER
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Name | DR. TODD COHRON
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Credential | OD
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Telephone | 270-526-6800
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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 | 1372 DT
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License Number State | KY
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