Individual
DR. TIMOTHY ROBERT DOSTALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
411 EAST AVE, ELYRIA, OH 44035
(440) 323-5709
Mailing address
411 EAST AVE, ELYRIA, OH 44035
(440) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3387T414
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0462495
—
OH
Enumeration date
02/06/2006
Last updated
03/21/2008
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