Greenbrier Physicians, Inc. Optical Shop

NPI #1861629917 in Ronceverte, West Virginia

Provider Information

NPI Number: 1861629917
Entity Type: Organization
Organization Name: Greenbrier Physicians, Inc. Optical Shop
Subpart: Yes (part of a larger organization)
Parent Organization: GREENBRIER PHYSICIANS, INC.
Primary Specialty: Technician/Technologist - Ophthalmic
Enumeration Date: Jun 16, 2009
Last Updated: Jun 16, 2009

Practice Location

Address: 200 MAPLEWOOD AVE
City: Ronceverte
State: West Virginia
ZIP Code: 24970-1334
Phone: (304) 647-1147

Authorized Official

Name: MR. JOHN D. TROUT
Title: CLINIC ADMINISTRATOR
Phone: (304) 647-1140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist	156F00000X
Technician/Technologist - Contact Lens — Contact Lens	156FC0800X
Technician/Technologist - Contact Lens Fitter — Contact Lens Fitter	156FC0801X
Technician/Technologist - Ophthalmic Assistant — Ophthalmic Assistant	156FX1101X
Technician/Technologist - Ophthalmic — Ophthalmic	156FX1100X	Primary

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