Individual
THOMAS M KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
570 DOVER CENTER RD, BAY VILLAGE, OH 44140-2361
(440) 871-1139
(440) 871-0222
Mailing address
457 DOVER CENTER RD, BAY VILLAGE, OH 44140-2357
(440) 871-1139
(440) 871-0222
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3675 T836
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0528094
—
OH
Enumeration date
09/16/2006
Last updated
10/01/2014
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