Organization
CHERYL L BENNETT OD PLLC
Active
Other names
The Spectacle Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL L BENNETT OD (DOCTOR/OWNER)
(681) 892-0393
Entity
Organization
Contact information
Practice address
28 VIRGINIA AVE, PETERSBURG, WV 26847-1740
(304) 642-4490
Mailing address
28 VIRGINIA AVE, PETERSBURG, WV 26847-1740
(681) 892-0393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
984-IOD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102000000
—
WV
Enumeration date
01/21/2017
Last updated
06/23/2020
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