Organization
WAYNE DOUGHERTY DBA WHEELING OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE DOUGHERTY (OWNER OPTICIAN)
(304) 232-6501
Entity
Organization
Contact information
Practice address
1101 MARKET STREET, WHEELING, WV 26003-2905
(304) 232-6501
(304) 232-6502
Mailing address
1101 MARKET STREET, WHEELING, WV 26003-2905
(304) 232-6501
(304) 232-6502
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
05 7 00045
WV
332H00000X
Eyewear Supplier
Primary
0507000045
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151762000
—
WV
Enumeration date
03/05/2008
Last updated
03/05/2008
Update your record
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