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Organization
RETINA VITREOUS ASSOCIATES INC
Active
Organization
RETINA VITREOUS ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNDA M KALUCKI (ADMINISTRATOR)
(419) 517-6599
Entity
Organization
Contact information
Practice address
2865 N REYNOLDS RD, SUITE 230, TOLEDO, OH 43615-2068
(419) 578-4367
(419) 537-5639
Mailing address
6591 W CENTRAL AVE, SUITE 202, TOLEDO, OH 43617-1087
(419) 517-6599
(419) 517-0503
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0384936
—
OH
Enumeration date
02/22/2006
Last updated
04/05/2017
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