Individual
MELVIN LEROY MCKINNEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
605 BLAND ST, BLUEFIELD, WV 24701
(304) 327-5316
Mailing address
605 BLAND ST, BLUEFIELD, WV 24701
(304) 327-5316
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151419000
—
WV
Enumeration date
01/05/2007
Last updated
03/24/2008
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