Individual
ETHAN T MENGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
409 N COURT ST, MEDINA, OH 44256-1869
(330) 725-4680
(330) 633-7165
Mailing address
PO BOX 207170, DALLAS, TX 75320-7173
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.006684
OH
Other
Enumeration date
05/30/2018
Last updated
06/08/2021
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