Organization
CHARLES B TWIGG
Active
Other names
Berryville Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES BAYLISS TWIGG O.D. (OWNER)
(540) 955-5051
Entity
Organization
Contact information
Practice address
33 W MAIN ST, BERRYVILLE, VA 22611-1340
(540) 955-5051
(540) 955-5052
Mailing address
33 W MAIN ST, BERRYVILLE, VA 22611-1340
(540) 955-5051
(540) 955-5052
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000137
VA
332H00000X
Eyewear Supplier
0618000137
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6502970001
DME NSC PTAN
VA
05
—
9232397
—
VA
Enumeration date
04/07/2011
Last updated
11/08/2011
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