Individual
DR. LORI MICHELE ANGOTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
120 MEDICAL PARK DR, SUITE 104, BRIDGEPORT, WV 26330-9012
(304) 842-4000
(304) 842-8002
Mailing address
531 MUSGRAVE ST, CLARKSBURG, WV 26301-4141
(304) 626-3678
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
990-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102007000
—
WV
Enumeration date
03/26/2007
Last updated
09/16/2014
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