| NPI | 1447203088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA R WOLSIEFER Credentialing Specialist 330-884-6584 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2025-01-06 |