Organization
ABDUL QOTAYNAH O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDULWAHED HAMOUD QOTAYNAH O.D. (OWNER)
(440) 974-6793
Entity
Organization
Contact information
Practice address
7850 MENTOR AVE, SUITE 368, MENTOR, OH 44060-5520
(440) 974-6793
(440) 974-6621
Mailing address
7850 MENTOR AVE, SUITE 368, MENTOR, OH 44060-5520
(440) 974-6793
(440) 974-6621
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5148 T2047
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2390087
—
OH
Enumeration date
03/01/2007
Last updated
08/22/2020
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