Organization
WHITESTAR PROFESSIONAL CORPORATION
Active
Other names
Skyvision Centers
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL WHITE MD (OWNER)
(440) 892-3931
Entity
Organization
Contact information
Practice address
3600 KOLBE RD, SUITE 230, LORAIN, OH 44053-1654
(440) 892-3931
Mailing address
3600 KOLBE RD, SUITE 230, LORAIN, OH 44053-1654
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2534574
—
OH
Enumeration date
05/02/2007
Last updated
06/25/2008
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