| |
632 Vine St, Ste 301, Cincinnati, OH 45202-2425 | |
(513) 621-0979 | |
(513) 421-5345 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 632 Vine St, Cincinnati, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326212929 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 4194-T055 (Ohio) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
632 Vine St., Ste 301, Cincinnati, OH 45202-2436 Ph: (513) 621-0979 | 632 Vine St, Ste 301, Cincinnati, OH 45202-2425 Ph: (513) 621-0979 |