Organization
J. EDGAR EVANS O.D., INC.
Active
Parent organization
J. EDGAR EVANS O.D., INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
J. EDGAR EVANS O.D., INC.
Authorized official
MRS. SHIRLENE SHERWOOD (OFFICE MANAGER)
(740) 384-2015
Entity
Organization
Contact information
Practice address
11 S PENNSYLVANIA AVE, WELLSTON, OH 45692-1255
(740) 384-2015
(740) 384-5634
Mailing address
11 S PENNSYLVANIA AVE, WELLSTON, OH 45692-1255
(740) 384-2015
(740) 384-5634
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2942/T1049
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235445
—
OH
Enumeration date
04/13/2012
Last updated
04/13/2012
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