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Organization

DR. RONALD L. DETWILER, O.D. INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD L DETWILER (OPTOMETRIST)
(330) 385-3898
Entity
Organization

Contact information

Practice address
15655 STATE RT 170, SUITE C, EAST LIVERPOOL, OH 43920-9069
(330) 385-3898
(330) 385-5772
Mailing address
15655 STATE ROUTE 170, SUITE C, EAST LIVERPOOL, OH 43920-9069
(330) 385-3898
(330) 385-5772

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
3166 T1622
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0324741
OH
Enumeration date
09/17/2007
Last updated
11/16/2007
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