| |
16215 Madison Ave, Lakewood, OH 44107-5618 | |
(216) 237-5888 | |
(216) 521-3338 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 16215 Madison Ave, Lakewood, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689132797 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
6801 Brecksville Road, Suite 20 Rk2-7, Independence, OH 44131-5058 Ph: (216) 636-8926 | 16215 Madison Ave, Lakewood, OH 44107-5618 Ph: (216) 237-5888 |