Individual
DR. BLAKE MITNICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
211 W MAIN ST, FLOYD, VA 24091-3190
(540) 745-8733
(540) 745-6644
Mailing address
211 W MAIN ST, FLOYD, VA 24091-3190
(540) 745-8733
(540) 745-6644
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000582
VA
Other
Enumeration date
01/28/2006
Last updated
07/08/2007
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