| |
1074 West Mcpherson Highway, Clyde, OH 43410 | |
(419) 547-9126 | |
(419) 547-0387 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 1074 West Mcpherson Highway, Clyde, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043330871 | NPI | - | NPPES |
2276059 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 5022 (Ohio) | Primary |
Mailing Address | Practice Location Address |
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1074 West Mcpherson Highway, Clyde, OH 43410 Ph: (419) 547-9126 | 1074 West Mcpherson Highway, Clyde, OH 43410 Ph: (419) 547-9126 |