Organization
NEWARK VISION CARE LLC
Active
Other names
Trillium Vision Care of New Lexington, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS J RYEN OD (PRESIDENT/OWNDER)
(614) 893-8114
Entity
Organization
Contact information
Practice address
391 LINCOLN PARK DR, NEW LEXINGTON, OH 43764-1080
(740) 342-1784
(740) 342-1791
Mailing address
PO BOX 540, NEW LEXINGTON, OH 43764-0540
(740) 342-1784
(740) 342-1791
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0425236
—
OH
Enumeration date
11/10/2020
Last updated
12/04/2020
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