Organization
PROVISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BEECHER OD (OWNER)
(304) 744-4017
Entity
Organization
Contact information
Practice address
306 SOUTHRIDGE BLVD, SOUTH CHARLESTON, WV 25309-9434
(304) 744-4017
(304) 744-4018
Mailing address
306 SOUTHRIDGE BLVD, SOUTH CHARLESTON, WV 25309-9434
(304) 744-4017
(304) 744-4018
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2030-IOD
WV
Other
Enumeration date
01/17/2017
Last updated
10/19/2017
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