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) 885-0006
Entity
Organization
Contact information
Practice address
1412 N AUGUSTA ST, STAUNTON, VA 24401
(540) 885-0006
(540) 885-5276
Mailing address
1412 N AUGUSTA ST, STAUNTON, VA 24401
(540) 885-0006
(540) 885-5276
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000690
VA
Other
Enumeration date
11/15/2006
Last updated
07/11/2008
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