Individual
COURTNEY LYNN POLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
303 W FIFTH ST, MARYSVILLE, OH 43040-0396
(937) 644-2075
(937) 644-2017
Mailing address
PO BOX 396, 303 W FIFTH ST, MARYSVILLE, OH 43040-0396
(937) 644-2075
(937) 644-2017
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2995T96
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P00478013
—
OH
Enumeration date
08/30/2006
Last updated
07/08/2007
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