| |
805 Patriot Dr Ste E, Wellington, OH 44090-8951 | |
(440) 647-0004 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 805 Patriot Dr Ste E, Wellington, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063920130 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Ohio) | Secondary |
332H00000X | Eyewear Supplier | (Ohio) | Primary |
Mailing Address | Practice Location Address |
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6801 Brecksville Rd, Suite 20, Rk2-7, Independence, OH 44131-5062 Ph: (216) 636-4969 | 805 Patriot Dr Ste E, Wellington, OH 44090-8951 Ph: (440) 647-0004 |