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Individual

DR. DANIEL D.T. FARNSWORTH IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
137 MAIN AVE, WESTON, WV 26452-1944
(304) 269-2020
(304) 269-2020
Mailing address
137 MAIN AVE, WESTON, WV 26452-1944
(304) 269-2020
(304) 269-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
823OD
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0148280001
ADMINISTAR FEDERAL
WV
05
0149630000
WV
Enumeration date
12/06/2005
Last updated
10/08/2009
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