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General NPI Number Information
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NPI Number | 1982482170
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Entity Type | Individual
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Provider Name | NORMAN TALBERT ABSHIRE JR. LICENSED OPTICIAN
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Gender | Male
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 345 COMMONWEALTH AVE
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City | WYTHEVILLE
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State | VA
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Zip | 24382
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Country | US
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Telephone | 540-498-8638
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Fax |
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Provider Business Mailing Address
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Address Line | 345 COMMONWEALTH DR
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1169
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Country | US
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Telephone | 276-228-4484
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1101001709
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License Number State | VA
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