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Individual

MARY LYNNE BLEVINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
503 E MAIN ST, LOUISVILLE, OH 44641-1421
(330) 875-2300
(330) 875-4110
Mailing address
503 E MAIN ST, LOUISVILLE, OH 44641-1421
(330) 875-2300
(330) 875-4110

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3739
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0561315
OH
01
410046640
RAILROAD MEDICARE
OH
Enumeration date
11/06/2006
Last updated
10/27/2008
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