| NPI | 1417355223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L DYWER Credentialing Supervisor 419-824-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |