Organization
EYE BONE, LLC
Active
Other names
Chardon Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTINE JOHN KELLIS MD (PRESIDENT)
(440) 285-2900
Entity
Organization
Contact information
Practice address
150 SEVENTH AVE, CHARDON, OH 44024-2908
(440) 285-2900
(440) 286-2905
Mailing address
150 SEVENTH AVE, CHARDON, OH 44024-2908
(440) 285-2900
(440) 286-2905
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
0979AS
OH
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
PENDING
OH
Other
Enumeration date
06/04/2010
Last updated
04/25/2023
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