# ROHOLT VISION INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205871621
- **Authorized official:** DIANE BONTRAGER (ADMINISTRATOR)
- **Authorized official phone:** (330) 305-2200

## Contact information

- **Practice address:** 1039 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4228
- **Practice address phone:** (330) 965-6410
- **Mailing address:** 5890 MAYFAIR RD, CANTON, OH 44720-1547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2285254 | — | OH |