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Organization

EXCELLENCE IN EYE CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN HARRIS (ADMINISTRATOR)
(330) 722-1313
Entity
Organization

Contact information

Practice address
3609 MEDINA RD, MEDINA, OH 44256-8181
(330) 722-1313
(330) 723-3003
Mailing address
3609 MEDINA RD, MEDINA, OH 44256-8181
(330) 722-1313
(330) 723-3003

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
332H00000X
Eyewear Supplier

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00638575
RAILROAD MEDICARE
Enumeration date
05/18/2006
Last updated
10/09/2012
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