Organization
CENTER FOR ADVANCED EYE SURGERY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA R WOLSIEFER (CREDENTIALING SPECIALIST)
(330) 884-6584
Entity
Organization
Contact information
Practice address
1031 W WESTERN RESERVE RD, POLAND, OH 44514-3541
(330) 965-0900
(330) 743-8368
Mailing address
1031 W WESTERN RESERVE RD, POLAND, OH 44514-3541
(330) 965-0900
(330) 743-8368
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0548AS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2145182
—
OH
01
—
490004288
RAILROAD MEDICARE
OH
Enumeration date
11/21/2005
Last updated
01/06/2025
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