Individual
HOLBROOK RILES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2485 POSSUM RUN RD, MANSFIELD, OH 44903-9447
(419) 756-7295
(419) 756-7574
Mailing address
949 STATE ROUTE #314 SOUTH, MANSFIELD, OH 44903-7797
(419) 756-7295
(419) 756-7574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3710/P1203
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0546172
—
OH
Enumeration date
06/02/2005
Last updated
03/03/2014
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