Individual
S LOUIS BERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15171 BURCHAM RD, LOGAN, OH 43138-8995
(740) 385-6545
Mailing address
15171 BURCHAM RD, LOGAN, OH 43138-8995
(740) 385-6545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2458763
OH
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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