Individual
JOHNATHAN LOWELL BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
240 W COOK RD, MANSFIELD, OH 44907-2451
(419) 525-3737
(419) 525-3740
Mailing address
240 W COOK RD, MANSFIELD, OH 44907-2451
(419) 525-3737
(419) 525-3740
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1952DT
KY
152W00000X
Optometrist
Primary
6265
OH
Other
Enumeration date
06/17/2014
Last updated
06/26/2015
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