Individual
DR. MARK F KAPUSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
30851 EUCLID AVE, SUITE 4, WILLOUGHBY, OH 44094
(440) 944-5155
(440) 943-9460
Mailing address
30851 EUCLID AVE, SUITE 4, WILLOUGHBY, OH 44094
(440) 944-5155
(440) 943-9460
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3511T508
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0474259
—
OH
Enumeration date
11/28/2006
Last updated
12/06/2012
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