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Individual

MR. CHRISTIAN A KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1001 S DEFIANCE ST, 1001 SOUTH DEFIANCE ST, ARCHBOLD, OH 43502-1617
(419) 445-5436
(419) 446-4818
Mailing address
1001 S DEFIANCE ST, P.O. BOX 38, ARCHBOLD, OH 43502-1617
(419) 445-5436
(419) 446-4818

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
611174299
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0716620001
PALMETTO GBA
05
0768129
OH
01
KI0655791
ADMINISTAR
Enumeration date
07/17/2006
Last updated
09/25/2008
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