| NPI | 1972834307 |
|---|---|
| Doing Business As | GENOA FAMILY EYECARE |
| Entity Type | Organization |
| Authorized Contact | WILLIAM R KEGERIZE Owner 419-855-3640 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OH OH5558) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2016-09-27 |