Individual
DR. MICHELE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
100 NITRO MARKET PL, CROSS LANES, WV 25313-4401
(304) 769-2253
(304) 769-2254
Mailing address
1542 THOMAS CIR, CHARLESTON, WV 25314-1623
(304) 344-0162
(304) 769-2254
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV851OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0619845
PTAN
WV
Enumeration date
05/14/2007
Last updated
03/02/2013
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