Organization
CANADIAN VALLEY VISION CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN D O'DONNELL O.D. (PRESIDENT)
(405) 379-3610
Entity
Organization
Contact information
Practice address
121 W MAIN ST, HOLDENVILLE, OK 74848-3229
(405) 379-3610
(405) 379-2019
Mailing address
PO BOX 897, HOLDENVILLE, OK 74848-0897
(405) 379-3610
(405) 379-2019
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2576
OK
152WC0802X
Corneal and Contact Management Optometrist
2576
OK
152WL0500X
Low Vision Rehabilitation Optometrist
2576
OK
152WP0200X
Pediatric Optometrist
2576
OK
Other
Enumeration date
09/23/2008
Last updated
06/29/2009
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