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General NPI Number Information
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NPI Number | 1689674863
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Entity Type | Individual
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Provider Name | DAVID A CANTLEY OD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 112 COLUMBIA POINT DR STE 102
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City | RICHLAND
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State | WA
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Zip | 99352-4390
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Country | US
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Telephone | 509-943-6565
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Fax | 509-946-6416
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Provider Business Mailing Address
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Address Line | 112 COLUMBIA POINT DR STE 102
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City | RICHLAND
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State | WA
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Zip | 99352
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Country | US
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Telephone | 509-943-6565
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Fax | 509-946-6416
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1755
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License Number State | WA
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