| NPI | 1659784965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE MORAN Office Manager 330-565-4195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3166 T46977) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4027 T1760) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |