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Individual

DR. CALEB NELSON TENNANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
511 5TH ST, MOUNDSVILLE, WV 26041-1901
(304) 845-1560
(304) 845-6381
Mailing address
PO BOX 708, MOUNDSVILLE, WV 26041-0708
(304) 845-1560
(304) 845-6381

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1071
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810018443
WV
Enumeration date
07/25/2009
Last updated
04/06/2021
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