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Organization

HETZLER OCULAR PROSTHETIC, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHY J HETZLER B.C.O. (PRESIDENT)
(317) 598-6298
Entity
Organization

Contact information

Practice address
130 TRI COUNTY PKWY, STE 201, CINCINNATI, OH 45246-3235
(513) 771-6029
Mailing address
130 TRI COUNTY PKWY, STE 201, CINCINNATI, OH 45246-3235
(513) 771-6029

Taxonomy

Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
0.11
OH
335E00000X
Prosthetic/Orthotic Supplier
O.11
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000029685
ANTHEM BCBS
OH
05
2046995
OH
05
90000902
KY
01
A1789
CHOICECARE
OH
Enumeration date
06/21/2005
Last updated
09/11/2025
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