Michelle Renee Wickline O.D.

NPI 1174521850 - Optometrist - 152W00000X

NPI Details
NPI 1174521850
Gender Female
Enumeration Date 07/07/2005
Last Updated 06/29/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
RT 1 BOX 75-4
SALEM WV, 26426, US
Phone (304) 782-1005
Fax (304) 782-3303
Business Location
RT 1 BOX 75-4
SALEM WV, 26426, US
Phone (304) 782-1005
Fax (304) 782-3303
Toxanomy
Taxonomy Code 152W00000X
License State West Virginia
License Number 913OD
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According to our database, Dr. Michelle Renee Wickline O.D. NPI is 1174521850, taxonomy code is 152W00000X and license number is 913OD, license state is located at West Virginia. Michelle Renee Wickline O.D. physically located at Rt 1 Box 75-4, Salem WV, 26426. NPI Number Michelle Renee Wickline O.D. has the Individual type.

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1174521850 NPI number is provided on an as is basis without warranty of any kind. 1174521850 is maintained by the National Plan & Provider Enumeration System. The contents of Michelle Renee Wickline O.D. are for informational purposes only.