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Individual

ELIZABETH NOEL DISTEFANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
42 MCGINNIS DR, WAYNE, WV 25570-9553
(304) 272-5136
(304) 272-6261
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618002273
VA
152W00000X
Optometrist
Primary
2045-IOD
WV

Other

Enumeration date
08/14/2011
Last updated
05/28/2024
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