Organization
FAMILY FIRST VISION CARE KENTUCKY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE JANDERNAL (CREDENTIALING SPECIALIST)
(732) 236-7067
Entity
Organization
Contact information
Practice address
2850 CENTRE DR STE 6A, BEAVERCREEK, OH 45324-8611
(937) 429-4060
Mailing address
316 S HAMILTON RD, GAHANNA, OH 43230-3350
(614) 676-0550
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
06/27/2023
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