Individual
DR. MARK ALLEN CENEVIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
911 HEBRON RD, HEATH, OH 43056-1182
(740) 522-2553
(740) 522-5346
Mailing address
977 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-1454
(740) 522-2553
(740) 522-5346
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3785
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0792316
—
OH
Enumeration date
08/04/2006
Last updated
07/08/2007
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