Individual
BRYCE TANNER PEEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6010 US ROUTE 60 E, BARBOURSVILLE, WV 25504-1029
(304) 733-0809
Mailing address
6010 US ROUTE 60 E, BARBOURSVILLE, WV 25504-1029
(304) 733-0809
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2080-IOD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080-IOD
WV BOARD OF OPTOMETRY
WV
Enumeration date
05/17/2021
Last updated
05/28/2021
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