Organization
ANTONINI OCULAR PROSTHETICS, LLC
Active
Parent organization
ANTONINI OCULAR PROSTHETICS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANTONINI OCULAR PROSTHETICS, LLC
Authorized official
MR. CHRISTOPHER ANTONINI (OWNER)
(304) 594-0719
Entity
Organization
Contact information
Practice address
1 STADIUM DR, WVU EYE INSTITUTE, MORGANTOWN, WV 26505
(304) 594-0719
(304) 241-1858
Mailing address
2208 SURREY DR, MORGANTOWN, WV 26505-2926
(304) 594-0719
(304) 241-1858
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381002299
—
WV
Enumeration date
02/07/2014
Last updated
02/07/2014
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