Organization
TERRY L WILLIAMS O D INC
Active
Other names
Glen Dale Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY L WILLIAMS OD (OWNER/OPTOMETRIST)
(304) 843-1445
Entity
Organization
Contact information
Practice address
12 WHEELING AVE, GLEN DALE, WV 26038-1529
(304) 843-1445
(304) 843-1446
Mailing address
12 WHEELING AVE, GLEN DALE, WV 26038-1529
(304) 843-1445
(304) 843-1446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
645D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720254
MOUNTAIN STATE BLUE CROSS
WV
Enumeration date
11/18/2005
Last updated
02/23/2009
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