Doctor Name: | MRS. MARLEIGH HELEN MCNEALUS |
NPI Number: | 1669692786 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OPTICIAN |
License Number: | 02800000269 |
Business Practice Address: | 4363 Route 7a Village Mall Manchester Center, VT - 052550567 |
Business Phone Number: | 8023622020 |
Business Fax Number: | 8023622524 |
Mailing Address: | Po Box 567, MANCHESTER CENTER |
State: | VT |
Postal Code: | 052550567 |
Phone Number: | 8023622020 |
Fax Number: | 8028622524 |
NPI Enumeration Date: | 04/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 02800000269 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |