Individual
THOMAS ALAN BANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2034 RIO HILL CTR, CHARLOTTESVILLE, VA 22901-1150
(434) 978-7750
(434) 975-0822
Mailing address
516 EASTBROOK DR, CHARLOTTESVILLE, VA 22901-1135
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001177
VA
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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