Organization
DR PATRICK HENRY OD LLC
Active
Other names
HENRY PATRICK DR SOLE MEMBER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOPE D WCISLAK (BILLING MANAGER)
(419) 824-3318
Entity
Organization
Contact information
Practice address
6790 PROVIDENCE ST, WHITEHOUSE, OH 43571
(419) 877-1188
(419) 877-1156
Mailing address
109 W WAYNE ST, MAUMEE, OH 43537-2150
(419) 893-6841
(419) 893-4894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OH5163
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2196672
—
OH
Enumeration date
04/27/2007
Last updated
07/01/2008
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