Organization
NEW BOSTON VISION CENTER LLC
Active
Organization
NEW BOSTON VISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L DEPUGH OD (OWNER)
(740) 456-4143
Entity
Organization
Contact information
Practice address
3955 RHODES AVE, NEW BOSTON, OH 45662
(740) 456-4143
(740) 456-6070
Mailing address
3955 RHODES AVE, NEW BOSTON, OH 45662-4950
(740) 456-4143
(740) 456-6070
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3664
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0459454
—
OH
01
—
DG4949
RAILROAD MEDICARE
—
Enumeration date
02/20/2018
Last updated
07/20/2018
Update your record
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