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Organization

DRIVING PARK VISION CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLAYTON NATHANIEL HICKS OD (OPTOMETRIST)
(614) 253-5593
Entity
Organization

Contact information

Practice address
1489 E LIVINGSTON AVE, COLUMBUS, OH 43205-2931
(614) 253-5593
Mailing address
1489 E LIVINGSTON AVE, COLUMBUS, OH 43205-2931
(614) 253-5593

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OH 2946
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0455896
OH
Enumeration date
02/25/2008
Last updated
12/12/2011
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