Individual
DANIEL J DEMARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 E MAIN ST, CLARKSBURG, WV 26301-2193
(304) 624-5642
Mailing address
393 EMILY DR, CLARKSBURG, WV 26301-5505
(304) 624-5642
(304) 624-1599
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
804D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150956000
—
WV
Enumeration date
11/21/2006
Last updated
04/07/2020
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