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Organization

GREENBRIER PHYSICIANS, INC. OPTICAL SHOP

Active
Parent organization
GREENBRIER PHYSICIANS, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
GREENBRIER PHYSICIANS, INC.
Authorized official
MR. JOHN D. TROUT (CLINIC ADMINISTRATOR)
(304) 647-1140
Entity
Organization

Contact information

Practice address
200 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-1147
(304) 647-3006
Mailing address
200 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-1147
(304) 647-3006

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
156FC0800X
Contact Lens Technician/Technologist
156FC0801X
Contact Lens Fitter
156FX1100X
Ophthalmic Technician/Technologist
Primary
156FX1101X
Ophthalmic Assistant

Other

Enumeration date
06/16/2009
Last updated
06/16/2009
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