Individual
DR. JOHN ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4690 MIDWAY MALL, ELYRIA, OH 44035-2469
(440) 324-4557
Mailing address
4690 MIDWAY MALL, ELYRIA, OH 44035-2469
(440) 324-4557
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4146T114
OH
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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