Individual
DR. LOUIS J STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
306 SOUTHRIDGE BLVD, SOUTH CHARLESTON, WV 25309-9434
(304) 744-4017
Mailing address
1542 THOMAS CIR, CHARLESTON, WV 25314-1623
(304) 344-0162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV859OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0668717
PTAN
WV
Enumeration date
05/14/2007
Last updated
03/03/2013
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