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Individual

NANCY A COLLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
107 E FOSTER ST, LEWISBURG, WV 24901-1409
(304) 645-7000
Mailing address
107 E FOSTER ST, LEWISBURG, WV 24901-1409
(304) 645-7000

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
615-OD
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0150163000
WV
Enumeration date
03/17/2006
Last updated
03/06/2011
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