MEDICARE: TO HEALTHY EYES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0690-OD	WV

General Provider Information

NPI Number	:	1144350075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TO HEALTHY EYES

Provider Business Mailing Address
First Line	:	4008 MACCORKLE AVE SW
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1510
Country	:	US
Telephone Number	:	304-744-9533
Fax Number	:

Provider Business Practice Location Address
First Line	:	4008 MACCORKLE AVE SW
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1510
Country	:	US
Telephone Number	:	304-744-9533
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MELVIN LEE MANN
Credential	:	O.D.
Telephone Number	:	304-744-9533

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	08/22/2020

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Directions to “TO HEALTHY EYES ” Practice Location

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