Individual
HALLINA NICOLE PORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
107 DOCTORS DR, BRIDGEPORT, WV 26330-1720
(304) 842-6226
Mailing address
1307 DEER RUN, MORGANTOWN, WV 26508-9177
(304) 288-2325
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2037-IOD
WV
Other
Enumeration date
07/23/2017
Last updated
07/23/2017
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