Organization
STACEY YOUNG OD INC
Active
Organization
STACEY YOUNG OD INC
Active
Other names
Eyecare Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY YOUNG OD (OWNER)
(330) 966-2400
Entity
Organization
Contact information
Practice address
4139 FULTON DR NW, CANTON, OH 44718-2819
(330) 966-2400
Mailing address
4139 FULTON DR NW, CANTON, OH 44718-2819
(330) 966-2400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4648
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2373864
—
OH
Enumeration date
01/11/2017
Last updated
01/11/2017
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