Individual
DR. DOUGLAS J WINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
140 W SPRING ST, SAINT MARYS, OH 45885-2312
(419) 394-2397
(419) 394-2398
Mailing address
140 W SPRING ST, SAINT MARYS, OH 45885-2312
(419) 394-2397
(419) 394-2398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3979
OH
152W00000X
Optometrist
Primary
T1670
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0916941
—
OH
Enumeration date
09/25/2006
Last updated
09/29/2010
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