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General NPI Number Information
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NPI Number | 1962975045
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Entity Type | Organization
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Legal Business Name | MARTINSBURG FAMILY EYE CARE, PLLC
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 55 MERIDIAN PKWY STE 105
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City | MARTINSBURG
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State | WV
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Zip | 25404-5422
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Country | US
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Telephone | 304-231-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MERIDIAN PKWY STE 105
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City | MARTINSBURG
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State | WV
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Zip | 25404-5422
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Country | US
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Telephone | 304-231-6599
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TROY MYSLIWIEC
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Credential | O.D.
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Telephone | 304-231-6599
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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 |
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License Number State |
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