Organization
NORTH COAST OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A BASHORE O.D. (OWNER)
(440) 428-2172
Entity
Organization
Contact information
Practice address
6380 N RIDGE RD, MADISON, OH 44057-2548
(440) 428-2172
(440) 428-8677
Mailing address
6380 N RIDGE RD, MADISON, OH 44057-2548
(440) 428-2172
(440) 428-8677
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4001
OH
Other
Enumeration date
07/17/2007
Last updated
12/03/2007
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