Organization
C R DECASTECKER OD INC
Active
Organization
C R DECASTECKER OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER R DECASTECKER OD (OWNER)
(440) 946-6662
Entity
Organization
Contact information
Practice address
34690 VINE ST, WILLOWICK, OH 44095-5118
(440) 946-6662
(440) 946-6981
Mailing address
34690 VINE ST, WILLOWICK, OH 44095-5118
(440) 946-6662
(440) 946-6981
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2197046
—
OH
Enumeration date
05/20/2008
Last updated
07/24/2008
Update your record
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