Individual
DR. ELIZABETH MUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2013 STATE ROUTE 59, KENT, OH 44240-4113
(330) 678-0201
(330) 678-4272
Mailing address
2013 STATE ROUTE 59, KENT, OH 44240-4113
(330) 678-0201
(330) 678-4272
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4833
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0713339
—
OH
01
—
0942140001
NSC
OH
05
—
2053950
—
OH
Enumeration date
07/26/2005
Last updated
12/31/2013
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