Individual
GARY G VERONNEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1102 MAIN ST, RAINELLE, WV 25962-1298
(304) 438-8574
(304) 438-8753
Mailing address
1102 MAIN ST, RAINELLE, WV 25962-1298
(304) 438-8574
(304) 438-8753
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
753D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150799000
—
WV
Enumeration date
03/16/2007
Last updated
04/24/2012
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