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Individual

DR. JOHN ANTHONY WIENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1090 STATE ROUTE 28, MILFORD, OH 45150-4936
(513) 575-9464
(513) 575-9466
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.004061
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
92734892
MEDICARE, UNSPECIFIED
OH
01
WI0734892
MEDICARE
OH
Enumeration date
11/30/2006
Last updated
02/08/2022
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