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Individual

MRS. MARY JANE TUDOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
834 ROBERT C BYRD DRIVE UNIT B, SOPHIA, WV 25921
(304) 683-3580
(304) 683-3582
Mailing address
PO BOX 103, 500 EAST RAILROAD AVE, SOPHIA, WV 25921
(304) 683-3580
(304) 683-3582

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
WV

Other

Enumeration date
07/11/2008
Last updated
07/11/2008
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