Organization
ROBERT M. BRENNER O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT M. BRENNER O.D. (OWNER)
(419) 525-0030
Entity
Organization
Contact information
Practice address
70 PARK AVE W, MANSFIELD, OH 44902-1624
(419) 525-1207
(419) 525-0030
Mailing address
70 PARK AVE W, MANSFIELD, OH 44902-1624
(419) 525-1207
(419) 525-0030
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
3398
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036255
—
OH
Enumeration date
11/19/2007
Last updated
08/24/2010
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