Organization
KYLE A. BRODIE, O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE A. BRODIE O.D. (OWNER)
(419) 931-2020
Entity
Organization
Contact information
Practice address
107 S WALNUT ST, WOODVILLE, OH 43469-1333
(419) 849-3811
(567) 482-4006
Mailing address
107 S WALNUT ST, WOODVILLE, OH 43469-1333
(419) 849-3811
(567) 482-4006
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049232
—
OH
Enumeration date
01/14/2008
Last updated
12/29/2023
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