Provider Demographics
NPI:1891238242
Name:WEST POINT OPTICAL
Entity Type:Organization
Organization Name:WEST POINT OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-545-4465
Mailing Address - Street 1:3593 CAPITAL CITY MALL DR
Mailing Address - Street 2:738
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-7011
Mailing Address - Country:US
Mailing Address - Phone:717-737-3462
Mailing Address - Fax:
Practice Address - Street 1:3593 CAPITAL CITY MALL DR
Practice Address - Street 2:738
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7011
Practice Address - Country:US
Practice Address - Phone:717-737-3462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty