Organization
EYE CARE ON THE RIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAD L WHEATLEY O.D. (OPTOMETRIST)
(276) 728-9323
Entity
Organization
Contact information
Practice address
843 W STUART DR, HILLSVILLE, VA 24343-1577
(276) 728-9323
Mailing address
843 W STUART DR, HILLSVILLE, VA 24343-1577
(276) 728-9323
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001276
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821077686
WHEATLEY NPI
—
Enumeration date
05/04/2011
Last updated
08/31/2011
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