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Organization
EYE SPECIALIST INC
Active
Organization
EYE SPECIALIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY SHULTZ OD (CENTER DIRECTOR)
(800) 948-3937
Entity
Organization
Contact information
Practice address
505 WEST EMMITT AVENUE, SUITE 4, WAVERLY, OH 45690-1084
(740) 941-3937
(740) 941-3786
Mailing address
50 N PLAZA BLVD, CHILLICOTHE, OH 45601-1757
(866) 587-8790
(740) 774-4061
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2368941
—
OH
Enumeration date
05/06/2006
Last updated
09/15/2014
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