Organization
O VICTOR WEATHERHOLT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTIS VICTOR WEATHERHOLT O.D. (OWNER OF CORPORATION)
(434) 385-5318
Entity
Organization
Contact information
Practice address
1912 GRAVES MILL RD, LYNCHBURG, VA 24502-4237
(434) 385-7898
(434) 385-1421
Mailing address
1912 GRAVES MILL RD, LYNCHBURG, VA 24502-4237
(434) 385-7898
(434) 385-1421
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000350
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009200703
—
VA
Enumeration date
10/06/2011
Last updated
12/06/2011
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