Organization
MPG LLC
Active
Other names
Shenandoah Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P GOWEN SR. OD (OWNER)
(540) 434-6622
Entity
Organization
Contact information
Practice address
1870 RESERVOIR ST, HARRISONBURG, VA 22801-8742
(540) 434-6622
(540) 434-4187
Mailing address
1870 RESERVOIR ST, HARRISONBURG, VA 22801
(540) 434-6622
(540) 434-4187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831170026
—
VA
Enumeration date
04/04/2007
Last updated
01/12/2010
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