Individual
BRETT K RADOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
149 MAIN ST, SPENCER, WV 25276-1414
(304) 927-5112
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6884
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV0730
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720163
BLUECROSS BLUESHIELD
WV
05
—
0150656000
—
WV
Enumeration date
09/08/2005
Last updated
02/09/2023
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