Individual
MARK DAVID HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
784 E MAIN ST STE D, LANCASTER, OH 43130-3983
(740) 654-9909
(740) 654-9969
Mailing address
784 E MAIN ST STE D, LANCASTER, OH 43130-3983
(740) 654-9909
(740) 654-9969
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4713-T1502
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2197251
—
OH
Enumeration date
09/02/2005
Last updated
10/23/2017
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