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Individual

DR. JOSEPH P. LEISRING I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3814 BROADWAY, GROVE CITY, OH 43123-2234
(614) 871-2080
(614) 871-1301
Mailing address
3814 BROADWAY, GROVE CITY, OH 43123-2234
(614) 871-2080
(614) 871-1301

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3548/T538
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410011217
RAILROAD MEDICARE
OH
Enumeration date
09/28/2005
Last updated
05/02/2012
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