Organization
FAMILY VISION CARE OF WAVERLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG G MONTAVON O.D (PRESIDENT)
(740) 947-8191
Entity
Organization
Contact information
Practice address
414 W EMMITT AVE, WAVERLY, OH 45690-1008
(740) 947-8191
(740) 947-5554
Mailing address
414 W EMMITT AVE, WAVERLY, OH 45690-1008
(740) 947-8191
(740) 947-5554
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3556/T794
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0471976
—
OH
Enumeration date
10/17/2007
Last updated
02/27/2008
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