Organization
MADISON EYE CARE OF PORT CLINTON LLC
Active
Organization
MADISON EYE CARE OF PORT CLINTON LLC
Active
Other names
MADISON EYE CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE KOUBEK OD (DOCTOR/PART OWNER)
(440) 892-5367
Entity
Organization
Contact information
Practice address
820 JEFFERSON ST, PORT CLINTON, OH 43452-2416
(419) 732-2828
Mailing address
26927 DETROIT RD, WESTLAKE, OH 44145-2370
(440) 892-5367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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