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Organization

MARK F. KAPUSTA O.D. INC

Active
Other names
Mark F. Kapusta O.D.
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NICOLE RENAE MCCALLION (MEDICAL SECRETARY)
(440) 944-5155
Entity
Organization

Contact information

Practice address
30851 EUCLID AVE, SUITE 4, WILLOUGHBY, OH 44094-3198
(440) 944-5155
(440) 943-9460
Mailing address
30851 EUCLID AVE, SUITE 4, WILLOUGHBY, OH 44094-3198
(440) 944-5155
(440) 943-9460

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3511T508
OH

Other

Enumeration date
04/22/2008
Last updated
04/22/2008
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