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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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