Provider Demographics
NPI:1932291416
Name:BECHTEL, THERESA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIE
Last Name:BECHTEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1099 BROOKDALE ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3950
Mailing Address - Country:US
Mailing Address - Phone:276-656-2021
Mailing Address - Fax:276-656-2051
Practice Address - Street 1:1049 BROOKDALE ST STE C
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3972
Practice Address - Country:US
Practice Address - Phone:276-656-2021
Practice Address - Fax:276-656-2051
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001184152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist