Organization
LEE EYEWEAR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA DIANE ROSS (PRESIDENT OWNER)
(304) 949-5171
Entity
Organization
Contact information
Practice address
2700 E DUPONT AVE STE 10, BELLE, WV 25015-1842
(304) 949-5171
Mailing address
PO BOX 11237, CHARLESTON, WV 25339
(304) 949-5171
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151338000
—
WV
Enumeration date
09/13/2006
Last updated
07/21/2022
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