Provider Demographics
NPI:1962975045
Name:MARTINSBURG FAMILY EYE CARE, PLLC
Entity type:Organization
Organization Name:MARTINSBURG FAMILY EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:MYSLIWIEC
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-231-6599
Mailing Address - Street 1:55 MERIDIAN PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-5422
Mailing Address - Country:US
Mailing Address - Phone:304-231-6599
Mailing Address - Fax:
Practice Address - Street 1:55 MERIDIAN PKWY STE 105
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-5422
Practice Address - Country:US
Practice Address - Phone:304-231-6599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty