Individual
BRIAN D LOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
125 SUFFOLK AVE, RICHLANDS, VA 24641-2434
(276) 963-0808
(276) 935-2993
Mailing address
PO BOX 45923, BALTIMORE, MD 21297-5923
(877) 969-0392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1011-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705926
MOUNTAIN STATE BLUE CROSS
WV
01
—
1458599
UMWA
WV
Enumeration date
02/22/2007
Last updated
10/04/2022
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