| |
6079 Brandt Pike, Huber Heights, OH 45424 | |
(937) 237-8669 | |
(937) 237-9019 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist |
Location | 6079 Brandt Pike, Huber Heights, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609914829 | NPI | - | NPPES |
2480668 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 4554 (Ohio) | Primary |
156F00000X | Technician/technologist | S5371 (Ohio) | Primary |
Mailing Address | Practice Location Address |
---|---|
6079 Brandt Pike, Huber Heights, OH 45424 Ph: (937) 237-8669 | 6079 Brandt Pike, Huber Heights, OH 45424 Ph: (937) 237-8669 |