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Individual

DR. ETHAN WALLACE LEYDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Mailing address
6284 WAYNESBURG RD NW, WAYNESBURG, OH 44688-9410
(330) 605-9851

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6476
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/16/2016
Last updated
08/18/2021
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