| Doctor Name: | DR. MARY LEE PEMBERTON |
| NPI Number: | 1003802422 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | O.D. |
| License Number: | 0618000738 |
| Business Practice Address: | 2522 Jefferson Hwy Suite 106 Waynesboro, VA - 229808503 |
| Business Phone Number: | 5409468727 |
| Business Fax Number: | 5409495526 |
| Mailing Address: | 2522 Jefferson Hwy, Suite 106 WAYNESBORO |
| State: | VA |
| Postal Code: | 229808503 |
| Phone Number: | 5409468727 |
| Fax Number: | 5409495526 |
| NPI Enumeration Date: | 09/21/2005 |
| NPI Last Update Date: | 02/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 0618000738 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |