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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