| NPI | 1609929439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITNEE LEE BURGIO Billing Specialist 513-984-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3199) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 3535) |
| 152W00000X Optometrist (Licence: OH 5337) | |
| 152W00000X Optometrist (Licence: OH 4454) | |
| 152W00000X Optometrist (Licence: OH 4279) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2012-07-09 |