Individual
RUSSELL W. BEATTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
131 LOUISA AVE., MINERAL, VA 23117
(540) 894-5600
Mailing address
PO BOX 70, MINERAL, VA 23117-0070
(540) 894-5600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000009
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009230041
—
VA
01
—
061232
ANTHEM DOMINION VA POWER
VA
Enumeration date
07/26/2006
Last updated
04/07/2008
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