Commonwealth Vision Center P.c.

NPI #1578651097 in Blackstone, Virginia

Provider Information

NPI Number: 1578651097
Entity Type: Organization
Organization Name: Commonwealth Vision Center P.c.
Primary Specialty: Optometrist
Enumeration Date: Oct 10, 2006
Last Updated: Oct 19, 2009

Practice Location

Address: 1447 SOUTH MAIN STREET
City: Blackstone
State: Virginia
ZIP Code: 23824
Phone: (434) 292-6393

Authorized Official

Name: LEONARD BRINKLEY WHITESIDE III, OD
Title: PRESIDENT
Phone: (434) 292-6393

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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