Organization
PETE AND MARIETTA VESTAL PTRS
Active
Other names
Vestal & Vestal Optometrists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIETTA TEMPLIN VESTAL O.D. (OPTOMETRIST PARTNER)
(423) 639-2002
Entity
Organization
Contact information
Practice address
910 TUSCULUM BLVD STE 2, GREENEVILLE, TN 37745-4004
(423) 639-2002
(423) 638-4522
Mailing address
910 TUSCULUM BLVD STE 2, GREENEVILLE, TN 37745-4004
(423) 639-2002
(423) 638-4522
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000000490
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3517736
—
TN
05
—
3593480
—
TN
Enumeration date
03/06/2007
Last updated
08/11/2014
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