Organization
TIMOTHY DOSTALL OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY ROBERT DOSTALL OD (OWNER)
(440) 323-5709
Entity
Organization
Contact information
Practice address
411 EAST AVE, ELYRIA, OH 44035-5717
(440) 323-5709
Mailing address
411 EAST AVE, ELYRIA, OH 44035-5717
(440) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
3387T414
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0462495
—
OH
Enumeration date
03/25/2008
Last updated
03/25/2008
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