Organization
MOUNTAIN STATE EYE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY K RAPSON (ADMINISTRATOR)
(301) 722-6480
Entity
Organization
Contact information
Practice address
RR 3 BOX 3300, KEYSER, WV 26726-9481
(304) 788-7800
Mailing address
RR 3 BOX 3300, KEYSER, WV 26726-9481
(304) 788-7800
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
897-D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149776000
—
WV
Enumeration date
01/22/2007
Last updated
04/05/2012
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