Organization
DANIEL KINGSLEY O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL KINGSLEY OD (OPTOMETRIST/OWNER)
(434) 315-4036
Entity
Organization
Contact information
Practice address
100 N VIRGINIA ST, FARMVILLE, VA 23901-1537
(434) 392-8113
(434) 392-6271
Mailing address
100 NORTH VIRGINIA ST, P.O. BOX 303, FARMVILLE, VA 23901
(434) 392-8113
(434) 392-6271
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000544
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417063744
—
VA
Enumeration date
11/16/2017
Last updated
11/16/2017
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