Individual
KODY BRANDON PHILLIP LECURGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 N JAMES RD, COLUMBUS, OH 43219-1834
(614) 257-5200
Mailing address
83 HARTFIELD CT, POWELL, OH 43065-9499
(614) 915-5715
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.006956
OH
Other
Enumeration date
05/11/2021
Last updated
05/23/2022
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