Basic Information
| Provider Information | |||||||||
| NPI: | 1578758348 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARROW FAMILY EYECARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1663 VIRGINIA AVE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228028312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404427742 | ||||||||
| FaxNumber: | 5404428470 | ||||||||
| Practice Location | |||||||||
| Address1: | 1663 VIRGINIA AVE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228028312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404427742 | ||||||||
| FaxNumber: | 5404428470 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2007 | ||||||||
| LastUpdateDate: | 06/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | MARROW | ||||||||
| AuthorizedOfficialFirstName: | CHRISTI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5404427742 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.