Individual
ANGELLA BETH GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Mailing address
800 HOSPITAL DR, COLUMBIA, MO 65201-5275
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001731
VA
152WL0500X
Low Vision Rehabilitation Optometrist
0618001731
VA
Other
Enumeration date
07/20/2007
Last updated
05/19/2020
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