| NPI | 1528123403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L VENEZIANO Optometrist 614-837-3797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5344) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OH 25-299822) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2009-01-30 |