| NPI | 1861876088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY SEMENKO Billing/Credentialing Specialist 330-688-8244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3193 t15) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |