Individual
DR. JON RICHARD OBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O. D.
Contact information
Practice address
2500 MEADOWBROOK MALL, JC PENNEY OPTICAL, BRIDGEPORT, WV 26330-9792
(304) 842-8515
(214) 427-2588
Mailing address
965 STEWART ST, MORGANTOWN, WV 26505-1800
(304) 599-8380
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
619OD
WV
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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