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General NPI Number Information
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NPI Number | 1760489843
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Entity Type | Individual
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Provider Name | ROBERT MICHAEL KRYM O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 356 FRONT STREET
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City | LOVINGSTON
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State | VA
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Zip | 22949-0590
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Country | US
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Telephone | 434-263-5100
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Fax | 434-263-5908
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Provider Business Mailing Address
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Address Line | PO BOX 1290
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City | FOREST
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State | VA
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Zip | 24551-1290
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Country | US
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Telephone | 434-385-5600
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Fax |
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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 | 0618000296
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License Number State | VA
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