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General NPI Number Information
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NPI Number | 1902089766
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Entity Type | Organization
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Legal Business Name | PRACTICE OF OPTOMETRY, INC
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 2808 SCIOTO TRL
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2244
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Country | US
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Telephone | 740-353-2020
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Fax | 740-353-2020
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Provider Business Mailing Address
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Address Line | 2808 SCIOTO TRAIL
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2244
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Country | US
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Telephone | 740-353-2020
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Fax | 740-353-2020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN WYLIE BINNS
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Credential | O.D.
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Telephone | 740-353-2020
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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 | 3845T768
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License Number State | OH
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