Individual
TIMOTHY MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7990 SEVERHILL CT, DUBLIN, OH 43016-9235
(614) 946-1453
Mailing address
7990 SEVERHILL CT, DUBLIN, OH 43016-9235
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6297
OH
152WC0802X
Corneal and Contact Management Optometrist
6297
OH
Other
Enumeration date
06/12/2014
Last updated
06/14/2014
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