| NPI | 1972891315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD M WARNER Regional CFO 419-251-2130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |