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Individual

MARK ALAN BIDLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1183 WESTWOOD DRIVE, VAN WERT, OH 45891
(419) 238-9244
(419) 238-4695
Mailing address
1183 WESTWOOD DRIVE, VAN WERT, OH 45891
(419) 238-9244
(419) 238-4695

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3921/T1214
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000314744
BCBS
OH
05
2445296
OH
01
61143605100
BWC
OH
Enumeration date
02/01/2006
Last updated
02/07/2022
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