Individual
DR. AMANDA BREWER-LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
530 W RIDGE RD, SUITE B, WYTHEVILLE, VA 24382-1042
(276) 223-0033
(276) 223-0327
Mailing address
530 W RIDGE RD, SUITE B, WYTHEVILLE, VA 24382-1188
(276) 223-0033
(276) 223-0327
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000743
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010298458
—
VA
Enumeration date
09/29/2005
Last updated
04/19/2012
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