Moderneyes, PLLC
Optometrist in Charleston, WV. Organization (NPI-2).
NPI number1649933763
StatusActive
Last updated in NPPESMay 25, 2023
Details
- NPI
- 1649933763
- Entity type
- Organization (NPI-2)
- Legal business name
- Moderneyes, PLLC
- Organization subpart
- Yes
- Enumeration date
- Oct 15, 2021
- Certification date
- May 25, 2023
- Last updated
- May 25, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Other names
- Charleston Vision Source (Doing Business As)
Practice location
4202 Maccorkle Ave SeCharleston, WV 25304-2502
Phone 304-925-4761
Mailing address
1171 Creekstone RdgSouth Charleston, WV 25309-9476
Phone 304-545-8366
Authorized official
Laura M Suppa Sammons
Optometrist
3045458366
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All 31 Optometrist providers in Charleston · All 9,831 providers in Charleston
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